(navigation image)
Home American Libraries | Canadian Libraries | Universal Library | Community Texts | Project Gutenberg | Children's Library | Biodiversity Heritage Library | Additional Collections
Search: Advanced Search
Anonymous User (login or join us)
See other formats

Full text of "CSAP Substance Abuse Resource Guide: Lesbian, Gay, Bisexual, and Transgender Populations"



Center for 
Substance Abuse 

Substance Abuse and Mental 
Health Services Administration 


Lesbian, Gay, Bisexual, and 
Transgender Populations 

rlany lesbian, gay, bisexual, and transgender persons (LGBT) face 
discrimination. The psychological, physical, and sexual abuse that 
LGBT persons experience cause many to turn to alcohol and drug 
abuse or other forms of addiction. Others get caught up in sensa- 
tion-seeking subcultures. Some LGBT persons struggling with their 
sexual identity feel a severe enough alienation to turn to suicide. 

This resource guide provides information on substance abuse issues 
in the lesbian, gay, bisexual, and transgender communities, and most 
of the materials target these diverse populations. Also, the guide 
examines the linkages between substance abuse and the conse- 
quences of use, including HIV/AIDS. The reader will find a range of 
materials-from brochures to videos to abstracts, and an extensive 
list of organizations to contact for more information. It is our 
expectation that substance abuse and addiction counselors, doctors, 
family members, those in recovery, and those seeking help, will find 
the resources in this guide most useful. 

Nelba Chavez, Ph.D. 


Substance Abuse and Mental Health Services Administration 

Ruth Sanchez-Way, Ph.D. 

Acting Director, Center for Substance Abuse Prevention 
Substance Abuse and Mental Health Services Administration 

OMH-RC-Knowledge Center 

5515 Security Lane, Suite 101 

Rockville, MD 20852 


Books 1 

Booklets, Brochures, and 
Fact Sheets ... . 6 

Magazines and Newsletters .....9 

Classroom Materials 
and Kits 12 

Videos, Posters, and 
Other Items 13 

Studies, Articles, 
and Reports ... 19 

Prevalence of Use............... 19 

Policy 34 

Prevention . 36 

Treatment 39 

Organizations and 
Internet Sites .... .. .... 47 

- p .« RV "' Fs v., v 

Substance Abuse and Mental Health Services Administration 
Center for Substance Abuse Prevention 



Center for 
Substance Abuse 

Substance Abuse and Mental 
Health Services Administration 


Lesbian, Gay, Bisexual, and 
Transgender Populations 


Substance Abuse and Mental Health Services Administration 
"""*S£^' Center for Substance Abuse Prevention 



The listing of materials or programs in this resource guide does not constitute or imply endorsement 
by the Center for Substance Abuse Prevention, the Public Health Service, the Substance Abuse and 
Mental Health Services Administration, or the Department of Health and Human Services. The 
materials have been reviewed for accuracy, appropriateness, and conformance with public health 

This Substance Abuse Resource Guide was compiled from a variety of publications and data bases 
and represents the most current information to date. It is not an all-inclusive listing of materials on 
this topic. This guide will be updated regularly, and your comments or suggestions are welcome. To 
suggest information or materials that might be included in future editions, please write to 
SAMHSA's National Clearinghouse for Alcohol and Drug Information (NCADI), P.O. Box 2345, 
Rockville, MD 20847-2345. 

Produced by SAMHSA's National Clearinghouse for Alcohol and Drug Information, Denise C. 
Jones, editor. 

For further information on alcohol, tobacco, and illicit drugs, call 1-800-729-6686, 301-468-2600, or 
TDD 1-800-487-4889. Or visit us on our World Wide Web site at http://www.health.org. 

Please feel free to be a "copy cat," and make all the copies you want. You 
have our permission! 


Lesbian Health: Current Assessment and 
Directions for the Future 

The Institute of Medicine Committee on Les- 
bian Health Research Priorities convened a 
workshop in 1997 to examine specific issues 
related to research and lesbians' risk for cer- 
tain health conditions including: cancer, 
mental health problems, substance abuse, 
HIV infection, and sexually transmitted dis- 
eases. This report is based on the committee's 
deliberations and reflects its review and 
evaluation of the scientific literature on les- 
bian health and of information presented at 
the workshop. 

Editor: Solarz, A.L. 

Organization: Institute of 
Medicine, National Academy 

Year: 1 999 

Format: Book (paperback) 

Length: 256 pages 

Topic: Lesbian health 

Target Audience: Lesbians 
and other women, health 
providers, policymakers, and 
general public 

Availability: National 
Academy Press, 2101 
Constitution Avenue, N.W., 
Box 285, Washington, DC 
20055; 202-334-331 3 

Cost: $19.95 

Vastly More Than That 

Vastly More Than That is an analysis of gay 
men and lesbians that explore both the uni- 
versality of the recovery experience and the 
special nature of recovery as lesbians and gay 
men experience it. The stories look at the 
struggles and successes of those in recovery 
in the gay community. This book covers top- 
ics such as overcoming crippling self-hatred, 
dealing with compulsive behavior and addic- 
tion, and focusing on honest self-exploration. 

Author: Kettelhack, C. 

Organization: Hazelden 
Information and Educational 

Year: 1 999 

Format: Book 

Length: 224 pages 

Topic: Recovery from 
addiction and substance 

Target Audience: Lesbians 
and gay men 

Availability: Hazelden 
Information and Educational 
Services, 15251 Pleasant 
Valley Road, RO. Box 1 76, 
Center City, MN 5501 2- 
01 76; 800-328-0098 

Cost: $12.95 

Prevention Materials for Lesbian, Gay, Bisexual, and Transgender Populations 

Clad Da) 

Poet and playwright Joan Larkin's meditations 
for gay, lesbian, bisexual, and transgender people 
combine an accepting attitude towards sexual- 
ity with traditional recovery themes. 

Author: Larkin, ]. 

Organization: Hazelden 
Information and Educational 

Year: 1 998 

Format: Book 

Length: 400 pages 

Topic: Lesbians, gays, and 
bisexuals in recovery 

Target Audience: Lesbians, 
gay men, and bisexuals 

Availability: Hazelden 
Information and 
Educational Services, 
15251 Pleasant Valley 
Road, RO. Box 1 76, 
CenterCity, MN55012- 
01 76; 800-328-0098 

Cost: $1 1 

Lesbian and Gay Youth: Care and Counseling 

This book explores the mental and physical 
health needs of lesbian/gay/bisexual/ transgender 
(LGBT) youth. Not only does it assist LGBT youth 
and their families, it is also a useful resource for 
health care providers. Lesbian and Gay Youth 
covers the following areas: sexuality, body im- 
age, STDs, HIV, emotional health and well-be- 
ing, racial and ethnic diversity, physical disabili- 
ties, gender, depression, sex, suicide, pregnancy, 
relationships, alcohol and drugs, fitness, and 

Authors: Ryan, G; 
Futterman, D. 

Year: 1 998 

Format: Book (hardcover) 

Length: 175 pages 

Topic: Mental health of gay 
and lesbian youth 

Target Audience: Lesbian 
and gay youth 

Availability: Bookstores 
Cost: $45 

Substance Abuse Resource Guide 

Accepting Ourselves and Others— A 
Journey Into Recovery From Addictive and 
Compulsive Behaviors for Gays, Lesbians, 
and Bisexuals 

Fully revised, this second edition book ad- 
dresses the problems and needs specific to 
substance abusers in LGBT communities. It 
examines recovery as it pertains to LGBT per- 
sons, their friends, families, and treatment 
professionals. The book includes an entire 
section to assist professionals working with 
individuals from LGBT communities. 

Authors: Kominars, S.B.; 
Kominars, K.B. 

Organization: Hazelden 
Information and Educational 

Year: 1 996 

Format: Book 

Length: 300 pages 

Topic: Recovery from 
substance abuse and 

Target Audience: Gays, 
lesbians, and bisexuals 

Availability: Hazelden 
Information and Educational 
Services, 15251 Pleasant 
Valley Road, RO. Box 1 76, 
Center City, MN 5501 2- 
01 76; 800-328-0098 

Cost: $18.95 

Addictinn ft Recovery in Gay & leshian 

This book was published as a special issue of 
the Journal of Gay & Lesbian Social Services, 
Vol. 2, No. 1 , 1 995. Addiction & Recovery. . . 
features a review of alcohol and drug abuse 
incidence, chemical dependency and HIV in- 
fection, homophobia, relationship issues, 
spirituality in the gay community, and gay 
special interest groups in Alcoholics Anony- 

Editor: Kus, R.J. 

Yean 1995 

Format: Book (paperback) 

Length: 118 pages 

Topic: Substance abuse and 

Target Audience: Lesbian and 
gay persons in substance 
abuse recovery 

Availability: Bookstores 
Cost: $9.95 

Prevention Materials for Lesbian, Gay, Bisexual, and Transgender Populations 


Preventing Alcnhnl and Other Drug Problems in 
the Leshian and Gay Communities 

This is a comprehensive handbook that presents 
strategies to prevent alcohol and drug problems 
among lesbians and gay men. 

Author: Kelly, J. 

Organization: EMT Group, 

Year: 1995 

Format: Handbook 

Length: 70 pages 

Topic: Alcohol and sub- 
stance abuse prevention 

Target Audience: Lesbians 
and gay men 

Availability: Progressive 
Research and Training for 
Action; Lesbian, Gay, 
and Transgender 
Technical Assistance 
Project, 440 Grand 
Avenue, Suite 401, 
Oakland, CA 94610- 
5012; 510-465-0547 

Cost: Free to California 
residents and profession- 
als working in California 
($ .10 per page for non- 
California residents) 

Black Women's Health Book: Speaking fur 

In this expanded second edition, noted femi- 
nist writer and editor Evelyn C. White, along with 
over 50 African-American women, write about 
health issues that affect their community. Con- 
tributing writers include Alice Walker, Audre 
Lorde, Barbara Smith, Byllye Y. Avery, and bell 
hooks. The topics discussed include: homopho- 
bia, wholistic healing, HIV/AIDS, menopause, 
and more. 

Editor: White, E.C. 

Publisher: Seal Press 

Year: 1 994 

Format: Book 

Length: 396 pages 

Topic: African-American 
women's health 

Target Audience: African- 
American women 

Availability: Bookstores 
Cost: $16.95 

Body B Soul: The Black Woman's Guide to 
Physical Health B Emotional Weil-Being 

Developed in conjunction with the National 
Black Women's Health Project, this book is a 
comprehensive guide that addresses the physi- 
cal, emotional, and spiritual health of African- 
American women. It features in-depth informa- 
tion about a myriad of health problems. Also, 
first person narratives by women who talk about 
an array of health concerns are included in this 
large volume. Each chapter provides an exten- 
sive resource list. 

Editor: Villarosa, L. 

Publisher: Harper Perennial 

Year: 1 994 

Format: Book 

Length: 528 pages 

Topic: African-American 
women's health 

Target Audience: African- 
American women 

Availability: Bookstores 

Cost: $22 

Substance Abuse Resource Guide 

Lesbians and Gay Men: Chemical Depen- 
dency Treatment Issues 

Lesbians and Gay Men was published as a spe- 
cial issue of the Journal of Chemical Depen- 
dency Treatment, Vol. 5, No. 1, 1992. This 
book features several articles that cover a 
broad range of treatment issues for gays and 
lesbians in recovery. Also, it provides infor- 
mation for heterosexual therapists with gay 
and lesbian clients, particularly regarding ho- 
mophobia in the context of recovery. 

Author: Weinstein, D.L. 

Year: 1993 

Format: Book (paperback) 

Length: 175 pages 

Topic: Substance abuse 

Target Audience: Lesbian and 
gay persons and mental 
health professionals 

Availability: Bookstores 
Cost: $14.95 

Opening Doors — Making Substance Abuse 
and Other Services Mnre Accessible to 
Lesbian, Bay, and Bisexual Youth 

In this book, author Bonnie Simpson explores 
the risks, issues, and service needs unique to 
lesbian, gay, and bisexual youth. Using data 
drawn from a large-scale study of the experi- 
ences of the youth, Opening Doors offers 
managers and frontline health and social ser- 
vice workers a blueprint for providing acces- 
sible and equitable services to youth who are 
underserved in this area. 

Author: Simpson, B. 

Yean 1993 

Format: Book 

Length: 76 pages 

Topic: Substance abuse 

Target Audience: Lesbian, 
gay, and bisexual youth 

Availability: National 
Resource Center for Youth 
Services, The University of 
Oklahoma, 202 West 8th 
Street, Tulsa, OK 741 19- 
1419; 918-585-2986 

Cost: $1 5 

Prevention Materials for Lesbian, Gay, Bisexual, and Transgender Populations 

Ethical Funding for 1GBT 6 HIV/AIDS Commu- 
nity-Based Organizations: Practical Guidelines 
When Cnnsidering Tobacco, Alcohol and Phar- 
maceutical Funding 

This booklet assists LGBT persons and HIV/AIDS 
organizations to develop sponsorship guidelines 
when seeking corporate donations in the to- 
bacco, alcohol, and pharmaceutical industries. 
Each corporate sector has campaigns that target 
the LGBT community, and questions are raised 
about the congruency of organizations' missions, 
funding policies, and their relationship to prod- 
ucts that have adverse effects in the LGBT com- 
munity. The booklet provides examples of poli- 
cies that can be adopted by "community based 
organizations to protect the integrity of their 
organizations, enhance their overall funding 
strategy, and support the health and well-being 
of the LGBT community as a whole." 

Beoklets, Smbms, 
and f ant Sheets 

Author: Drabble, L 

Organization: Coalition of 
Lavendar Americans on 
Smoking and Health 
(CLASH) and the California 
Lavendar Smokefree Project 

Year: 1999 

Format: Booklet 

Length: 33 pages 

Topic: Funding by alcohol, 
tobacco, and pharmaceuti- 
cal companies 

Target Audience: LGBT and 
HIV/AIDS organizations 

Availability: CLASH c/o 
Progressive Research and 
Training for Action, 440 
Grand Avenue, Suite 
401 , Oakland, CA 
94610-5012; 510-465- 

Cost: Free to California 
residents and profession- 
als working in California 
($ .10 per page for non- 
California residents) 

Leshian, Bay, Bisexual and Transgender 
Resource File 

This document is a resource list of booklets, con- 
ference items, articles, and other materials that 
focus on the LGBT community and substance 

Organization: Progressive 
Research & Training for 
Action and the National 
Association of Lesbian & 
Gay Addiction Professionals, 

Year: 1 998 

Format: Booklet 

Length: 30 pages 

Topic: LGBT and substance 

Target Audience: General 

Availability: Progressive 
Research & Training; 
Lesbian, Gay & 
Transgender Technical 
Assistance Project, 440 
Grand Avenue, Suite 
401, Oakland, CA 
94610-5012; 510-465- 

Cost: Free to California 
residents and profession- 
als working in California 
($ .10 per page for non- 
California residents) 

Substance Abuse Resource Guide 

Slopping Stereotypes: Gays, lesbians, and 

This brochure focuses on the stereotypes ex- 
perienced by lesbians and gay men based in 
homophobic perspectives. It notes the diffi- 
culties of what it means to be "different," and 
how gays and lesbians have a greater pro- 
pensity to abuse alcohol often resulting from 
internal and external homophobia. Hain 
points out the importance of being true to 
self and accepting one's sexual orientation. 
The author provides a list of informational re- 
sources on self-help groups, such as Alcohol- 
ics Anonymous, with all-gay chapters. 

Author: Hain, D. 

Organization: Do It Now 

Year: 1 998 

Format: Brochure 

Length: 6 pages 

Topic: Alcohol abuse 

Target Audience: Gays and 

Availability: Do It Now 
Foundation, RO. Box 27568, 
Tempe, AZ 85285; 602-736- 

Cost: $.50 each for qty. of 
10; $3.95 for qty. of 50; $11 
for qty. of 1 00 

Empowerment ot Latioas in Recovery 

This booklet covers empowerment and the 
Latina, an overview of Latino culture, assimi- 
lation, acculturation and transculturation, and 
implications for treatment and recovery. 

Author: Gardea, L. 

Organization: PROTOTYPES 

Year: 1995 

Format: Booklet 

Length: 43 pages 

Topic: Substance abuse 

Target Audience: Latinas in 

Availability: Progressive 
Research and Training for 
Action; Lesbian, Gay & 
Transgender Technical 
Assistance Project, 440 
Grand Avenue, Suite 401 , 
Oakland, CA 94610-5012; 

Cost: Free to California 
residents and professionals 
working in California ($ .10 
per page for non-California 

Prevention Materials for Lesbian, Gay, Bisexual, and Transgender Populations 

Creating Visibility: Providing Lesbian-Sensitive 
and Lesbian-Specific Alcoholism Recovery 


This document, originally developed as a train- 
ing curriculum project of the Alcoholism Center 
for Women in Los Angeles, provides a clear over- 
view of issues for lesbians with alcohol-related 
problems, including: specific issues for lesbians 
of color, issues for lesbians who are trauma sur- 
vivors, and considerations for lesbian families. 
Practical strategies creating lesbian sensitive ser- 
vices in relation to outreach, administration, and 
program design are provided. 

Author: Underhill, B.L 

Year: 1 994 

Format: Booklet 

Length: 63 pages 

Topic: Alcoholism treatment 

Target Audience: Lesbians 

Availability: Progressive 
Research and Training for 
Action; Lesbian, Gay, 
and Transgender 
Technical Assistance 
Project, 440 Grand 
Avenue, Suite 401, 
Oakland, CA 94610- 
5012; 510-465-0547 

Cost: Free to California 
residents and profession- 
als working in California 
($ .10 per page for non- 
California residents) 

Other 'Gay Plague': Alcoholism in the Gay/ 
Lesbian Community 

This brochure describes the special problems 
and needs of gay and lesbian alcoholics. Re- 
sources and support group information is pro- 

Author: Hain, D. 

Organization: Do It Now 

Yean 1986 

Format: Brochure 

Length: 6 pages 

Topic: Alcohol abuse 
intervention and treatment 

Target Audience: Alcohol 
and drug treatment profes- 
sionals, gay men, and 

Availability: Do It Now 
Foundation, 2750 S. 
Hardy Drive, Suite 2, 
Tempe, AZ 85282; 602- 

Cost: Not listed 

Substance Abuse Resource Guide 

Fe'Mail Magazine 

This magazine educates lesbians about health 
and wellness. Fe*Mail includes information 
about activities and events in the lesbian com- 

Publisher: Borah, P. 

Year: Published monthly 

Format: Magazine 

Length: 16 pages 

Topic: Lesbian health and 

Target Audience: Lesbians 
(ages 30 years and older) 


Availability: Fe*Mail 
Magazine, RO. Box 75392, 
Washington, DC 20013; 

Cost: $20 for annual 

lithe Wind 

In the Wind includes features and informa- 
tion on the prevalence and prevention of 
AIDS in Native American communities. 

Publisher: National Native 
American AIDS Prevention 

Year: Published quarterly 

Format: Newsletter 

Length: 8 pages 

Topic: AIDS in Native 

Target Audience: Gay, 
lesbian, bisexual, and 
heterosexual Native Ameri- 

Availability: National Native 
American AIDS Prevention 
Center, 1 34 Linden Street, 
Oakland, CA 94607; 510- 

Cost: Free 

Prevention Materials for Lesbian, Gay, Bisexual, and Transgender Populations 

National Association of Lesbian and Gay Addic- 
tion Professionals (NA1GAPI 

This quarterly newsletter highlights issues con- 
cerning gays and lesbians and alcohol, tobacco, 
and drugs (ATD). Each issue includes informa- 
tion about upcoming conferences and events 
for people in the field, articles about health is- 
sues including addiction, HIV, and book reviews. 
Stories about ATD professionals who are mak- 
ing a difference in the gay and lesbian commu- 
nities are also featured. 

Publisher: National Associa- 
tion of Lesbian and Gay 
Addiction Professionals, Inc. 

Year: Published quarterly 

Format: Newsletter 

Length: 8 pages 

Topic: Alcohol and drug 
abuse prevention, interven- 
tion, and treatment 

Target Audience: Substance 
abuse prevention profession- 
als serving lesbian and gay 

Availability: National 
Association of Lesbian 
and Gay Addiction 
Professionals, Inc., c/o 
NAADAC, 1 91 1 North 
Fort Myer Drive, Suite 
900, Arlington, VA 
22209; 703-465-0539 

Cost: Not listed 

Winner of the National Health Information's 
1 996 and 1 998 Merit Award, Prevention Pipe- 
line is a bimonthly magazine that features ar- 
ticles and information on substance abuse pre- 
vention. It features research abstracts, descrip- 
tions of new materials, upcoming conferences, 
news from the field, funding resources, public 
service ads, and reprinted materials. Subscrib- 
ers are encouraged to share information pub- 
lished in Prevention Pipeline. 

Publisher: Center for 
Substance Abuse Prevention 

Year: Published bimonthly 

Format: Magazine 

Length: 60 pages 

Topic: Alcohol and sub- 
stance abuse 

Target Audience: Substance 
abuse prevention profession- 
als, educators, parents, 
teens, and adults 

Availability: SAMHSA's 
National Clearinghouse 
for Alcohol and Drug 
Information, PO. Box 
2345, Rockville, MD 
20847-2345; 800-729- 

Internet: www.health.org 

Cost: Subscriptions are 
$28 for domestic orders, 
$32 for international 


Substance Abuse Resource Guide 


Venus magazine features articles and adver- 
tisements that focus on the African Ameri- 
can lesbian, gay, bisexual, and transgender 
(LGBT) community. It also includes informa- 
tion that focuses on health and well-being. 

Publisher: Cothran Publica- 
tions, Inc. 

Year: Published quarterly 

Format: Magazine 

Length: 60 pages 

Topic: Issues and activities in 
the African American LGBT 

Target Audience: African 
American LGBT persons 

Availability: Cothran 
Publications, Inc., PO. Box 
1 50, Hastings on Hudson, 
NY 10706; 914-376-6161 

Cost: $14.95 for an annual 

Women in the life Magazine 

Women in the Life is a national publication 
that features articles, program events, and 
information on lesbians and bisexual women, 
including health and wellness issues. 

Publisher: Women in the Life 

Year: Published monthly 

Format: Magazine 

Length: 28 pages 

Topic: Issues and activities in 
the lesbian community 

Target Audience: Lesbians 
and bisexual women 

Availability: Women in the 
Life, 1611 Connecticut 
Avenue, NW, Suite 2-B, 
Washington, DC 20009; 

Cost: $20 for annual 

Lesbian, Gay, Bisexual, Transgender SIC 

SIG is a special interest group of NAADAC. 
Their newsletter premiered in spring 1999 
and it provides information on upcoming 
publications and events specifically related 
to the lesbian, gay, bisexual, and transgender 
(LGBT) community. 

Organization: National 
Association of Alcoholism 
and Drug Abuse Counselors 

Year: Published quarterly 

Format: Newsletter 

Length: 4 pages 

Topic: Substance abuse issues 

Target Audience: Lesbian, 
gay, bisexual, and 
transgender persons 

Availability: NAADAC SIGs, 
1 91 1 North Fort Myer Drive, 
Suite 900, Arlington, VA 
22209; 703-741 -7686, 800- 

Cost: $1 5 per year for 
NAADAC members 

Prevention Materials for Lesbian, Gay, Bisexual, and Transgender Populations 


Removing Barriers to Health Care for 
Lesbian, Gay, Bisexual & Transgendered 

Clients: A Model Provider Edocation Pro- 

This is a training curriculum and resource 
guide for health care providers. It addresses 
the barriers to health education, disease pre- 
vention, and treatment for lesbian, gay, bi- 
sexual, and transgender (LGBT) clients. 

Organization: National 
Lesbian and Cay Health 
Association and the 
Mautner Project for 
Lesbians with Cancer 

Year: 1997 

Format: Curriculum 

Length: 31 pages 

Topic: Health educa- 
tion — prevention and 


Target Audience: 

Lesbians, gays, bisexuals, 
and transgender persons 

Availability: Progressive 
Research and Training for 
Action; Lesbian, Gay, 
and Transgender 
Technical Assistance 
Project, 440 Grand 
Avenue, Suite 401, Oak- 
land, CA 9461 0-501 2; 

Cost: Free to California 
residents and profession- 
als working in California 
($ .10 per page for non- 
California residents) 

Relapse and HIV Risk— A Compooent of 
Hazelden's Complete Relapse Preventinn Skills 

This package combines a video, a pamphlet, and 
a workbook to maximize a person's learning po- 
tential about the hazards brought on by receiv- 
ing a positive HIV diagnosis. The viewer sees how 
others manage their behaviors to avoid chemical 
dependency relapse in the dramatic video. The 
interactive workbook encourages clients to de- 
velop their own relapse prevention plan to re- 
duce their risk of contracting HIV or begin using 
alcohol and drugs again. 

Authors: Swanson, J; 
Cooper, A. 

Organization: Hazelden 
Information and Educa- 
tional Services 

Year: 1 995 

Format: Various materials 

Length: Pamphlet — 32 
pages, workbook — 32 
pages, and videotape — 
15 minutes 

Topic: Substance abuse 

Target Audience: General 
public (adults) 

Availability: Hazelden 
Information and 
Educational Services, 
15251 Pleasant Valley 
Road, RO. Box 1 76, 
Center City, MN 55012- 
01 76; 800-328-0098 

Cost: Pamphlet— $2, 
workbook — $2.50, and 
videotape — $85 


Substance Abuse Resource Guide 

All God's Children 

A political, social, and religious analysis of 
sexual orientation in the context of African- 
American cultural values is explored in this 
documentary short. The video features the 
voices of politicians, religious leaders, intel- 
lectuals, families, and activists. "All God's 
Children" particularly looks at the impact of 
societal alienation and homophobia on gays 
and lesbians. 

Organization: Woman 
Vision Films, National 
Gay and Lesbian Task 
Force, and the National 
Black Lesbian and Gay 
Leadership Forum 

Year: 1 996 

Format: Videotape 

Length: 26 minutes 

Topic: Alienation and 
inclusion based on sexual 

Target Audience: Black 
gays and lesbians 

Mees, Pasters, 
and Itlier Items 

Availability: Transit Media 
Film Library, 22-D Holly- 
wood Ave., Hohokus, NJ 
07423; 800-343-5540 

Cost: $39.95 includes 
shipping and handling in the 

Facing the Challenge: Gay and Lesbian Teens 

Kathy Herbst discusses ways in which adults 
can communicate with gay and lesbian teens 
about their needs and concerns. 

Organization: Syndistar, Inc. 

Year: 1 996 

Format: Videotape 

Length: 51 minutes 

Topic: Gay and lesbian teens 
and substance abuse 

Target Audience: Lesbian and 
gay teens 

Availability: Syndistar, Inc., 
5801 River Road, New 
Orleans, LA 70123-5106; 

Cost: $79.95 

Prevention Materials for Lesbian, Gay, Bisexual, and Transgender Populations 


Safe "T" Lessons: HIV Prevention in the 
Transgender Community 

This unique video is a series of interviews with 
transgender persons who represent the ethno- 
cultural diversity and range of identities and ex- 
periences that constitute the transgender com- 
munities, including drag, cross-dressing, men and 
women of transexual experience, of all sexual 
orientations. The video chronicles the develop- 
ment and implementation of a New York City 
community-based peer implemented HIV and 
substance abuse prevention initiative that inte- 
grates community building with safer sex educa- 
tion and street outreach. Information on hor- 
mone needle exchange and medical concerns is 

Organization: Gender 
Identity Project, Lesbian 
and Gay Community 
Services Center 

Year: 1996 

Format: Videotape 

Length: 38 minutes 

Topic: Transgender HIV 
prevention and 
transgender community 

Target Audience: 
Transgender persons and 
service providers 

Availability: Gender 
Identity Project, Lesbian 
and Gay Community 
Services Center, One 
Little West 1 2th Street, 
New York, NY, 10014; 

Cost: $5 plus shipping 

101 Ways to Get High Without Drugs 

Both the poster and the pamphlet list more than 
100 creative alternatives to drug use, including: 
smell some flowers, play with your cat, go hik- 
ing, go to a movie, sit by the river, hang out with 
friends, and hug someone. 

Organization: ETR 

Year: 1995 

Format: Kit (poster and 

Length: 1 page each 

Topic: Drug abuse 

Target Audience: General 

Availability: ETR 
Associates, RO. Box 
1830, Santa Cruz, CA 
95061-1830; 800-321- 

Cost: Posters — $6 for 
qty. 1-99, $5.50 for qty. 
100-199, $5 for qty. 
200+ ; Pamphlet— $16 
for qty. 50, $30 for qty. 


Substance Abuse Resource Guide 

Open the Door 

These items feature a vibrant and colorful 
painting of culturally diverse people in con- 
versation. Around the border of the illustra- 
tion it reads, "Open the door. Swallow your 
pride. Pass the cup of friendship. Pour out 
your story. Open your heart." (Also available 
in Spanish.) 

Organization: FACE (Truth 
and Clarity on Alcohol) 

Year: 1994 

Format: Poster, T-shirt, 
bookmark, and table tent 

Length: Variable 

Topic: Alcohol abuse preven- 

Target Audience: Young adults 

Available: FACE, 105 West 
Fourth Street, Clare, Ml 
4861 7; 888-822-3223 

Cost: Poster— $5, T-shirt- 
Si 5, Bookmark (pkg. of 
200)— $50 (volume discount 
available), Table tent (pkg. of 
100) — $45 (volume discount 

Straight from the Heart 

This video explores the manifestations of ra- 
cial and sexual orientation bigotry from the 
perspective of parents with gay or lesbian chil- 
dren. A discussion guide is included. 

Organization: Woman Vision 

Year: 1994 

Format: Videotape 

Length: 24 minutes 

Topic: Gays and lesbians 
experience homophobia 

Target Audience: Gays and 
lesbians, and parents of gay 
and lesbian children 

Availability: Transit Media 
Film Library, 22-D Holly- 
wood Ave., Hohokus, NJ 
07423; 800-343-5540 

Cost: $39.95 includes 
shipping and handling in the 


Prevention Materials for Lesbian, Gay, Bisexual, and Transgender Populations 

AIDS Caregiving 

Tape one, side one: Voices of People Who 
Care — This explores the unique aspects of car- 
ing for someone with HIV disease, the problems 
and concerns of caregivers in diverse communi- 
ties, and how to cope with day-to-day aspects 
of caregiving. 

Tape one, side two: Caregiving at its Best — This 
side discusses the motivation of people to be- 
come AIDS caregivers, and the capacity for deep- 
ening relationships, support for caregivers, and 

Tape two, side one: Prescription for Burnout and 
Compassion Fatigue — This portion explores "on 
the job training" as a caregiver. Moreover, how 
does one deal with the caregiver's concerns 
when she/he is HIV positive? 

Tape two, side two: How Caregiving Changes 
You — This part explores a person's compassion 
and self-awareness, the caregivers' paradox, de- 
veloping a greater tolerance for ambiguity, dis- 
covering spirituality, and hope. 

Organization: Connecti- 
cut Clearinghouse 

Year: 1993 

Format: Audiocassette 

Length: Variable 

Topic: Caregiving to 
persons with AIDS 

Target Audience: Gays, 
lesbians, bisexuals, and 

Availability: Connecticut 
Clearinghouse, 334 
Farmington Avenue, 
Plainville, CT 06062; 

Cost: Loaned to 
Connecticut Clearing- 
house members free 
(requires residency in 
Connecticut). Contact 
the clearinghouse for 
membership informa- 

Lesbian Alcoholism and Recover}: A Selected 

This is a bibliography of materials specifically fo- 
cusing on alcoholism and the recovery process 
among lesbians. 

Author: Underhill, B.L 

Year: 1 993 

Format: Bibliography 

Length: 9 pages 

Topic: Alcoholism and 
substance abuse recovery 

Target Audience: Lesbians 

Availability: Progressive 
Research and Training for 
Action; Lesbian, Gay & 
Transgender Technical 
Assistance Project, 440 
Grand Avenue, Suite 
401, Oakland, CA 
94610-5012; 510-465- 

Cost: Free to California 
residents and profession- 
als working in California 
($ .1 per page for non- 
California residents) 


Substance Abuse Resource Guide 

Tap into a New Community Spirit 

Targeting alcohol consumption at festivals, the 
image features someone at a tap filling a cup 
with cherry soda instead of beer. Under the 
image it says, "Every year, thousands of towns 
across the country gear up for their annual 
festivals. Too often these events focus on al- 
cohol. This year, show kids the real meaning 
of community spirit. And let the good times 
roll!" This image speaks to the need to sub- 
stitute beer and alcohol with non-alcoholic 
beverages, which is particularly relevant for 
the annual gay pride festivals held around the 

Organization: FACE (Truth 
and Clarity on Alcohol) 

Year: 1 993 

Format: Poster, bookmark, 
and table tent 

Length: Variable 

Topic: Alcohol abuse preven- 

Target Audience: Young adults 

Availability: FACE, 105 West 
Fourth Street, Clare, Ml 
4861 7; 888-822-3223 

Cost: Poster— $5, T-shirt- 
Si 5, Bookmark (pkg. of 200) 
$50 (volume discount 
available), Table tent (pkg. of 
100)— $45 (volume discount 

Project Adept— Race, Culture and 
Ethnicity: Addressing Alcohol and Other 
Drag Problems 

This video is designed to enhance partici- 
pants' understanding of how their own eth- 
nic backgrounds affect patient care, to 
broaden their perspectives on substance 
abuse in different cultures, and to provide 
them with tools to better assess and diagnose 
substance abuse among a diverse patient 
population. (This video is from the curricu- 
lum by the same title.) 

Organization: Connecticut 

Year: 1992 

Format: Videotape 

Length: 34 minutes 

Topic: Alcohol and drug abuse 

Target Audience: Physicians 
and health care providers 

Availability: Connecticut 
Clearinghouse, 334 
Farmington Avenue, 
Plainville, CT 06062; 800- 

Cost: Not listed 

Prevention Materials for Lesbian, Gay, Bisexual, and Transgender Populations 


Say, Proud and Sober 

This video describes recovery from a gay view- 
point and how chemical dependency affects the 
gay population. 

Organization: Connecti- 
cut Clearinghouse 

Year: 1 990 

Format: Videotape 

Length: 30 minutes 

Topic: Substance abuse 

Target Audience: Jr. high 
and sr. high school youth 
and adults 

Availability: Connecticut 
Clearinghouse, 334 
Farmington Avenue, 
Plainville, CT 06062; 
800-232-4424 or 860- 

Cost: Not listed 

Living Proof 

Created as a collaboration between Gay Men's 
Health Crisis and the Center's alcohol and drugs 
program, Project Connect in 1 990, "Living Proof" 
documents the stories of a diverse group of les- 
bians, gay men, and bisexual and transgender 
persons in recovery from substance addiction and 
dealing with HIV/AIDS. Although the informa- 
tion in the section on medical issues is dated, 
the video portraits remain a moving testament 
to the power of community connections in re- 
covery and the importance of recognizing and 
supporting the special issues of lesbians, gay, bi- 
sexual, and transgender (LGBT) persons in need 
of prevention and treatment. 

Organization: Project 
Connect, Lesbian and 
Gay Community Services 

Year: 1990 

Format: Videotape 

Length: 21.5 minutes 

Topic: Lesbian, gay, 
bisexual, and transgender 
substance abuse recovery 
and HIV issues 

Target Audience: LGBT 
community and treat- 
ment providers 

Availability: Project 
Connect, Lesbian and 
Gay Community Services 
Center, One Little West 
1 2th Street, New York, 
NY 10014; 212-620- 

Cost: $5 plus shipping 

Too Close for Comfort 

This video challenges viewers to examine com- 
monly held misconceptions about gays and les- 
bians. It focuses on how stereotypes and preju- 
dice feed into homophobia, and recommends 
positive steps to end discrimination based on 
sexual orientation and HIV/AIDS. 

Organization: ETR 

Year: 1990 

Format: Videotape 

Length: 27 minutes 

Topic: HIV/AIDS educa- 

Target Audience: Young 
adults (lesbian, gay, 
bisexual, and hetero- 

Availability: ETR 

Associates, PO. Box 
1 830, Santa Cruz, CA 
95061-1830; 800-321- 

Cost: $1 89 


Substance Abuse Resource Guide 

Prevalence of Use 

Sex, Drugs, and the Culture of Transvestimo in 
Rio De Janeiro 

Inciardi, J.A.; Surratt, H.L; Paulo, R. T.; and Pok, 

The International journal of Transgenderism , 3:1 - 

2, January-June 1 999 
Available from James A. Inciardi, Center for Drug 

and Alcohol Studies, University of Delaware, 

77 East Main Street, Newark, DE 1 971 6; 302- 


This article focuses on the transvestite community 
in Brazil and how its "marginalization impacts the 
effectiveness of HIV prevention/ intervention pro- 
grams." A sample of 100 male transvestite sex 
workers were recruited between 1993 and 1997 
and AIDS risk behaviors were examined among 
them. Nearly half tested positive for HIV infection. 
(Funded by NIDA, this was a collaborative effort 

SMm, Mislss, 
and Reports 

between the University of Miami School of Medi- 
cine and the State University of Rio de Janeiro.) 
The purpose of the study was to establish a com- 
munity-based HIV/AIDS surveillance and monitor- 
ing system, and to develop and evaluate a cultur- 
ally appropriate prevention/ intervention program 
for cocaine users in Rio's favelas and "red light" 
districts. There were two phases of data collection: 
(1 ) street recruitment as part of the overall project's 
outreach and intervention, and (2) focus groups. 
Two cohorts of male transvestite prostitutes were 
included. Descriptive statistics were compiled on 
demographic characteristics, drug use, and sexual 
behaviors of participants. Multivariate logistic re- 
gression analyses were used. Recommendations for 
prevention include condom negotiation and em- 
powerment techniques, demonstration and distri- 
bution of female condoms (for anal sex), and needle 
cleaning techniques, given the non-hygienic use 
of needles for silicone injections. 

Geographic Differences in Non-Injection and 
Injection Substance Dse Amung HlV-Seropositive 
Men Who Have Sex With Men: Western Dnited 
States Versus Other Regions [Supplement to HIV/ 
AIDS Surveillance Study Group] 

Sullivan, PS.; Nakashima, A.K.; et al. 
Journal of Acquired Immune Deficiency Syndrome 
Human Retrovirol, 19(3): 266-273, 1998 

This study examines the prevalence of and factors 
associated with the use of alcohol and nonprescrip- 
tion drugs by HIV-seropositive men who have sex 
with men (MSM), and it describes variations in al- 
cohol and non-prescription drug use by geographic 
region. The authors analyzed data from a multistate, 
population- and facility-based interview study con- 
ducted in 12 U.S. States and metropolitan areas. 
Among 9,735 MSM with HIV infection or AIDS who 
completed a 45-minute interview, nearly one-third 
reported possible alcohol abuse. Large proportions 

of MSM also reported the use of marijuana (51 per- 
cent), non-injected cocaine use (31 percent), and 
crack cocaine use (16 percent) in the 5 years be- 
fore the interview. Smaller proportions of MSM re- 
ported ever having injected cocaine (1 3 percent), 
stimulants (8 percent), and heroin (8 percent). Re- 
sults of logistic regression indicated that in the 5 
years before the interview, white MSM were sig- 
nificantly (p < .01 ) more likely than referent (mostly 
Hispanic) MSM to report use of hallucinogens, 
marijuana, nitrites, noninjected amphetamines, 
and diazepam. Black MSM were significantly more 
likely than referent MSM to report use of race ver- 
sus referent MSM, and to report residing in the 
West versus East. The prevalence of alcohol and 
drug use among HIV-seropositive MSM is high, and 
prevalence and types of substance use differ by 
region and racial/ethnic group. To prevent HIV 
transmission in this population, health departments 
and community-based organizations must under- 
stand the unique local patterns of substance use to 
develop effective substance abuse prevention and 
treatment programs. 

Prevention Materials for Lesbian, Gay, Bisexual, and Transgender Populations 


Histories of Substance Use and Risk Behavior: 
Precursors to HIV Seroconversion in Homo- 
sexual Men 

Chesney, M.A.; Barrett, D.C.; and Stall, R. 
American Journal of Public Health, 88(1 ): 

Available from Margaret A. Chesney, Ph.D., 

Center for AIDS Prevention Studies, 74 

New Montgomery Street, Suite 600, San 

Francisco, CA 94105 

This study compared the history of substance use 
and episodic use in terms of HIV seroconversion. 
A sample of 337 baseline HIV-negative gay men 
was followed for 6 years. Bivariate and survival 
analyses were used to compare 39 converters with 
nonconverters on substance use behaviors. 
Seroconverters were consistently more likely to 
report use of marijuana, nitrite inhalants, amphet- 
amines, and cocaine than nonconverters. Consis- 
tent use of nitrite inhalants and amphetamines in- 
creases the relative risk of seroconversion, while 
episodic use does not. Both patterns of cocaine 
use increase seroconversion risk. There are three 
potential mechanisms for an increased risk of con- 
version due to consistent substance use. 

latina Lesbians and Alcnhol and Other Drugs: 
Sncial Work Implications 

Reyes, M. 

Alcoholism Treatment Quarterly, 16(1/2): 179- 

(Co-published simultaneously in Alcohol Use/ 

Abuse Among Latinos: Issues and Examples of 

Culturally Competent Services, edited by M. 

Delgado, New York: Haworth Press, 1 998.) 

This article was based on an ethnographic study in 
which 35 informants were interviewed. Informa- 
tion about substance abuse among Latina lesbians 
is featured in the article, along with recommenda- 
tions for treatment, research, and policy. 

Substance Abuse Resource Guide 

Self-Reports of Alcohol Use, Drug Use and Sexoal 
Behavior: Expanding Hie Timeline Follow-Back 

Midanik, L.T.; Hines, A.M.; et al. 

Journal of Alcohol Studies, 59(6): 681-689, 1998 

The purpose of this study is to compare reports of 
alcohol use, drug use, and sexual behavior from 
30-day summary measures with an expanded ver- 
sion of a Timeline Follow-back (Timeline) interview 
technique among gay/bisexual men entering out- 
patient substance abuse treatment at a gay-identi- 
fied agency. Respondents (N=41 8) first completed 
self-administered questionnaires covering the 30- 
day period prior to their last use of alcohol or drugs. 
Summary measures included alcohol use, number 
of days of use for five categories of drugs, and num- 
ber of episodes of anal intercourse (with and with- 
out condoms) by partner type (primary or second- 
ary). Participants then completed the Timeline in- 

terview procedure to recall their daily drinking, 
drug use, and sexual behavior during the same 30- 
day period. The findings indicate that the Timeline 
method yielded significantly lower estimates of 
mean number of drinks consumed when heavier 
than usual drinking days is included in the sum- 
mary measure (1 24 versus 1 47 drinks). Also, mean 
number of days drugs were used (9.3 versus 10.7) 
and mean number of episodes of anal intercourse 
with a primary partner (1.2 versus 2.2) were in- 
cluded. Differences generally remained significant 
when assessed by length of time between the study 
interview and last use of alcohol or drugs, with the 
exception of number of anal sex episodes with pri- 
mary partners. These findings indicate that Timeline 
estimates are lower than estimates using a more 
standard method (Summary measures). Discrep- 
ancies between these findings and those reported 
by other researchers indicate a need for further 
exploration of the effects of the mode of adminis- 
tration on various populations. 

The Association Between Health Risk Behaviors 
and Sexual Urientatioo Among a School-Based 
Sample of Adolesceots 

Garofalo, R.; Wolf, G; Dessel, S.; et al. 
Pediatrics, 101(5): 895-902, 1998 

This study is one of the first to research the asso- 
ciation between health risk behaviors and sexual 
orientation among a representative school-based 
sample of adolescents. Gay, lesbian, and bisexual 
youth were more likely than their peers to have 
been victimized and threatened and to have en- 
gaged in risk behaviors including multiple substance 
use, risky sexual behaviors, and suicide ideation. 

Prevention Materials for Lesbian, Gay, Bisexual, and Transgender Populations 


Assessing Sexual Compulsivity/Addiction in 

Chemically Dependent Can Men 

Amico, J.M. 

Addiction and Compulsivity, 4(4): 291 -300, 1 997 

This study distinguished between sexually com- 
pulsive behavior and coming out behaviors in gay 

men in chemical dependence treatment settings. 
The Sexual Behavior Assessment Tool (SBAT) was 
used to delineate sexual behaviors. The author rec- 
ommends that clinicians assess sexual compulsivity/ 
addiction in gay men, lesbians, and bisexuals 
through sex histories, assessment tools, and identi- 
fication of coping behaviors. 

Exploration of Substance Use Among Lesbian, 
Can, and Bisexoal Yooth: Prevalence and Corre- 

Rosario, M.; Hunter, J.; and Gwadz, M. 

Journal of Adolescent Research, 12(4): 454-476, 

Available from Margaret Rosario, Ph.D., HIV Cen- 
ter and Departments of Psychiatry and Socio- 
medical Sciences, Columbia University, 722 
West 168th Street, Unit 29, New York, NY 

The prevalence and correlates of substance use 
and abuse were explored among lesbian, gay 
male, and bisexual youth recruited from gay-fo- 
cused organizations in New York City. Lifetime 

substance use was prevalent and frequent, as was 
quantity of use and substance abuse symptoms. Few 
significant gender or ethnic differences emerged, 
but the significant differences unexpectedly indi- 
cated that the female youth were at greater risk for 
substance abuse than the male youth. Number of 
substances ever used and substance abuse symp- 
toms were associated with initiating alcohol and 
illicit drugs to cope with psychological issues. How- 
ever, the number of substances ever used and sub- 
stance abuse symptoms were not explained by so- 
cial learning theory, social control theory, or self- 
derogation theory when relations were explored. 
The findings are interpreted from the perspective 
of sexual identity, specifically that gay, lesbian, and 
bisexual youth may use substances to cope with 
the societal stigma of homosexuality. 

Substance Abuse Resource Guide 

Gays, Lesbians, and Bisexuals 

Cabaj, R.R 

Substance Abuse: A Comprehensive Textbook. J.H. 

Lowinson, R Rurz, etal., Baltimore: Williams 

and Williams, 1997, pp. 725-733 

This chapter discusses the nature of homosexual- 
ity and bisexuality; gay men, lesbians, and bisexu- 
als themselves; the substance abuse concerns 

among these people; and, the specific treatment 
issues that need to be addressed in working with 
gay men, lesbians, and bisexual men and women. 
Information included is identity formation of the 
above mentioned sexual orientations; the relation- 
ship between homosexuality and substance abuse; 
homosexuality, substance abuse and HIV; and spe- 
cial substance abuse treatment considerations for 
gay people. 

HIV Risk Factors Amony Gay, Bisexual, lesbian 
and Transgender Street Users 

Reback, C. 

NIDA Research Monograph Series 1 74, 462 pp, 

Problems of Drug Dependence 1 996: Proceedings 
of the 58th Annual Scientific Meeting: The Col- 
lege on Problems of Drug Dependence, Inc. 

Available from the U.S. Government Printing Of- 
fice, Washington, DC 

A community-based outreach and intervention pro- 
gram that targets high-risk gay, bisexual, lesbian, 
and transgender drug users on the streets of Holly- 
wood, CA, was examined. This program was based 

on a harm reduction model, measuring Outcome 
as any psychosocial, psychological, or physical re- 
duction in the harm that results from drug use. From 
1 995 to 1 996, 4,040 active users were contacted, 
and of those, in-depth interventions were con- 
ducted with 1,415 drug users. Street users con- 
tacted through this project were predominately gay 
and bisexual men. Twenty-four percent of street 
users were injectors, and they were less likely than 
non-injectors to be bisexual. Injectors were more 
likely to be Caucasian than non-injectors. Approxi- 
mately half of non-injectors and 68 percent of in- 
jectors engaged in sex work. Injectors were less 
likely to always use condoms than non-injectors, 
and the most commonly used drug was crystal 

Prevention Materials for Lesbian, Gay, Bisexual, and Transgender Populations 

The lavender Lotto: Lesbian/Bay Substance 
Abuse Numbers — Who Wins? Who Loses? 

Kennedy, N.J.; Marcelle, G. 
Paper presented at the National Lesbian and Gay 
Health Conference, July 28, 1997 

This presentation included prevalence estimates 
of substance abuse in the lesbian/gay community. 

Risk and protective factors are reviewed and ex- 
planations for the high prevalence rates are con- 
sidered. In conclusion, the presenters advocate that 
a working group assumes the responsibility for col- 
laborating with interested Federal researchers in de- 
termining accurate lesbian/gay substance abuse 
numbers. Such an effort will pay dividends to any- 
one interested in the health and well-being of the 
gay community. 

Update on Substance Abuse Prevention in 
Lesbian/Gay/ Bisexual/Transgender Communi- 

Marcelle, C. 

Prevention Pipeline, 10(5): 17-19, September/ 

October 1 997 
Available from SAMHSA's National Clearinghouse 

for Alcohol and Drug Information, RO. Box 

2345, Rockville, MD 20847-2345; 800-729- 


The National Association of Lesbian and Gay Ad- 
diction Professionals (NALGAP) announced the 
establishment of a clearinghouse on lesbian, gay, 
bisexual, and transgender (LGBT) substance 
abuse, and new guidelines for treatment programs 
serving this client population. Meanwhile, an his- 

toric effort at organizing LGBT communities for sub- 
stance abuse prevention in Los Angeles County also 
has been reported. Both the Alcoholism Center for 
Women (ACW) and the Los Angeles Gay and Les- 
bian Center have contracts from their county's Al- 
cohol and Drug Programs Administration to orga- 
nize prevention activities in the area. The two agen- 
cies developed separate but complementary plans 
in their proposals, both of which were ultimately 
funded. The core of the Los Angeles County plan 
has been the development of a countywide volun- 
teer organization to identify and plan for the sub- 
stance abuse prevention needs of lesbians, gay men, 
bisexuals, and transgender people. The popularity 
of methamphetamine as a gay partying drug is be- 
ginning to spread from West Coast cities, where it 
has been recognized as a major problem for sev- 
eral years. 


Substance Abuse Resource Guide 

Use of Alcohol Among lesbians: Research and 
Clinical Implications 

Hughes, T.L.; Wilsnack, S.C. 

American Journal of Orthopsychiatry, 67(1): 20-36, 


A review of the literature on the prevalence of al- 
cohol use and problems among lesbians reveals that 
the few studies yielding information on this popu- 
lation are beset by design and methodological 
problems. Those factors possibly associated with 
higher risk status of lesbians are identified, as are 
gaps in the literature, and implications for clinical 
practice and research are discussed. 

Condom Use Among Gay/Bisexual Male Substance 
Abusers Using the Timeline Follow-Back Method 

Crosby M.G.; Stall, R.; Paul, ].?.; et al. 
Addictive Behaviors, 21(2): 249-257, 1996 

Sexual risk for HIV transmission under the influ- 
ence of alcohol and/or other drugs is not simply a 
cause-effect relationship — not everyone who drinks 
or uses drugs has unprotected sex. The purpose of 
this study is to explore differences between sub- 
stance using gay/bisexual men who use condoms 
during anal sex from those who do not. These dif- 
ferences are identified by comparing men engaged 
in anal intercourse while under the influence of 
alcohol and/or drugs and are consistently protected 
to men who engage in anal sex while under the 
influence of alcohol and/or drugs and they are con- 
sistently unprotected. 

Gay/bisexual men entering substance abuse treat- 
ment at a gay-identified agency in San Francisco 
were recruited to complete surveys and to be in- 
terviewed about sexual behavior, substance use, 
and related variables using an extended version of 
the Timeline Follow-back (TL). The TL procedure 
uses a blank calendar form and a series of ques- 

tions to cue recall of drinking, drug use, and anal 
intercourse on each of the 30 days prior to the last 
date of alcohol and/or drug use. Men who consis- 
tently engaged in unprotected anal sex while un- 
der the influence of alcohol and/or drugs were sig- 
nificantly more likely to report having less than a 
college education (p = .04). Also, they were more 
likely to have an income of less than $20,000 (p = 
.01), more likely to use amyl nitrite (p = .01) and 
cocaine (p = .02), and more likely to report a higher 
frequency of anal sex (p = .007). In addition, they 
were less likely to approve of sex without love (p 
= .003), less likely to perceive that safer sex is the 
community norm (p < .001), and less likely to have 
encouragement from friends to practice safer sex 
(p = .001). However, HIV status did not differenti- 
ate between the two groups. These two groups 
provide clear and interesting contrasts in terms of 
behavior. Thus, comparisons of the factors influ- 
encing sexual safety in these subgroups may en- 
hance our understanding of risk taking. A better 
understanding of possible mediating variables can 
be important both in guiding future research in this 
area and in formulating intervention strategies to 
target gay men who drink or use drugs in combi- 
nation with sexual activity. 

Prevention Materials for Lesbian, Gay, Bisexual, and Transgender Populations 

Drug and Alcohol Use Among Lesbian and Gay 
People in a Southern U.S. Sample: Epidemiologi- 
cal, Cnmparative, and Methodological Findings 
from the Trilogy Project 

Skinner, W.F.; Otis, M.D. 

Journal of Homosexuality, 30(3): 59-92, 1996 

The Trilogy Project is a longitudinal study of les- 
bian and gay people living in and around two 
metropolitan areas in a southern State. The study 
was specifically designed to provide (1) epide- 
miological data on the lifetime, past year, and past 
month prevalence rates for the use of six illicit, 
four psychotherapeutic, and two licit drugs, and 

(2) comparative data to the National Household 
Survey on Drug Abuse (NHSDA). Self-report data 
were collected on 1,067 respondents using mul- 
tiple sampling strategies and a research design that 
yielded response rates averaging over 50 percent. 
Results indicated some age group differences in the 
prevalence of certain drugs by gay men were found 
to have significantly higher prevalence rates for the 
past year use of marijuana, inhalants, and alcohol, 
but not cocaine. While lesbian and gay people drink 
alcohol more frequently during the month than 
NHSDA respondents, few differences occurred be- 
tween the two samples for heavy alcohol consump- 
tion. Research questions suggested by the data and 
theoretical directions for the future research are 

The Epidemiology of Prohlem Drinking in Gay 
Men and Lesbians: A Critical Deview 

Bux, D.A. 

The Clinical Psychology Review, 16(4): 277-298, 

This article overviews literature related to the epi- 
demiology of alcohol use among lesbians and gay 

Health Care Needs of Gay Meo aod Lesbians in 
the United States 

American Medical Association (AMA) Committee 

on Scientific Affairs 
Journal of the American Medical Association, 

275(17): 1354-1358, 1996 

This article provides an overview of the demo- 
graphics and epidemiology of health status of gay 
men and lesbians. It provides a review of AMA 
studies. Among health indicators are sexual his- 
tory, AIDS, and medical decision making. Rec- 

ommendations are made for physicians working 
with this population, including: importance of a 
nonjudgmental attitude; education for physicians; 
education for homosexual individuals; use of na- 
tional and local experts by physicians to better un- 
derstand medical needs; work with the gay and 
lesbian community; support for a national survey 
that incorporates a representative sample of the U.S. 
population of all ages and that includes questions 
on sexual orientation and sexual behavior; and, to 
encourage research to identify unique health care 
issues of gay men and lesbians. 

Substance Abuse Resource Guide 

Ml Men, and Myths: Increased Risk in the Gay 

Marcelle, C. 

Prevention Pipeline, 9(3): 12-13, May/June 1996 
Available from SAMHSA's National Clearinghouse 
for Alcohol and Drug Information, RO. Box 
2345, Rockville, MD 20847-2345; 800-729- 

This article examines the dramatic increase in meth- 
amphetamine use in the gay, lesbian, bisexual, and 
transgender (LGBT) communities, particularly in the 

western United States. Some LGBT substance 
abuse program professionals note methamphet- 
amine is the second drug of choice for some gay 
men and it is increasing in popularity among lesbi- 
ans. This is in part attributed to methamphetamine's 
aphrodisiac effect. The increased sexual appetite 
results in much more unsafe sex practices, which 
leads to HIV/AIDS and other viral infections. Addi- 
tional physiological effects of methamphetamine 
can include cardiovascular problems, hypothermia, 
and even damage to the blood vessels resulting in 

Pervasive Effects of Childhood Sexual Ahose in 
Lesbians' Recovery from Alcohol Problems 

Hall, J.M. 

Substance Use and Misuse, 31(2): 225-239, 1996 

In narratives of 35 lesbians in alcohol recovery, 46 
percent unexpectedly disclosed having survived 
childhood sexual abuse (CSA), linking it with ad- 
diction and recovery experiences. This subgroup 
described unbounded difficulties that pervaded 
their lives well into recovery. They reported mul- 

tiple addictions, self-harm, isolation, sexual prob- 
lems, depression, self-loathing, physical illness, and 
inability to work more often than did other partici- 
pants. Those not reporting CSA were more so- 
cially and occupationally stable, self-satisfied, and 
physically well in recovery; their alcohol problems 
seemed circumscribed and responsive to conven- 
tional intervention. Conclusions indicate that CSA 
history may foster health risks that complicate al- 
cohol recovery, necessitating more comprehensive 
clinical attention. 

Sexual HIV Risk Among Gay and Bisexual Male 
Methamphetamine Users 

Frosch, D.; Shoptaw, S.; Huber, A.; Rawson, R.A.; 

and Ling, W. 
Journal of Substance Abuse Treatment, 13(6): 483- 

486, 1996 

This report provides a description of baseline drug 
use and HIV-related high-risk sexual behavior for 
gay or bisexual methamphetamine abusers who 
sought chemical dependency treatment between 
1989 and 1993. Participants were 28 metham- 
phetamine abusing or dependent gay or bisexual 
males who completed the NIDA/WAVE Question- 
naire, a semi-structured interview of HIV-related 

sexual behaviors. Alcohol consumption varied 
widely with 35.7 percent of the participants re- 
porting no alcohol use, 32.2 percent reporting 
monthly or weekly consumption, and 32.2 per- 
cent reported drinking several times per week 
or daily. Results show that for the 1 2 months 
prior to treatment, 62.5 percent of participants 
reported anal insertive sex without a condom, 
and 56.3 percent reported having sex with some- 
one with HIV. Drug use, but not alcohol con- 
sumption, before or during sex was frequent. Im- 
plications for treatment of gay and bisexual male 
methamphetamine abusers and prevention of 
HIV among this population are discussed. 

Prevention Materials for Lesbian, Gay, Bisexual, and Transgender Populations 


Speed Use and HIV Transmission 

Gorman, M. 

3 pp, June 1996 

Available from Progressive Research and Training 
for Action; Lesbian, Gay, and Transgender 
Technical Assistance Project, 440 Grand Av- 
enue, Suite 401, Oakland, CA 94610-5012; 

This paper provides information on metham- 
phetamine and HIV transmission, including 
action and epidemiology, the HIV connection, 
assessment, and treatment. 

Alcoholism and Drug Abuse in Gay and Lesbian 

Persons: A Review of Incidence Studies 

Bickelhaupt, E. E. 

journal of Gay and Lesbian Social Services, 2(1 ] 

This review article examines the incidence of 
alcoholism and other forms of drug abuse 
among gays and lesbians in the United States 
and one European society. The consensus is 
that about 25 percent of such persons suffer 
from definitive drug and alcohol abuse prob- 
lems, while an additional percentage experi- 
ence "suggestive or problematic" abuse pat- 

Chemical Dependency and HIV Infection 

Pohl, M.I. 

Journal of Gay and Lesbian Social Services, 2(1): 
15-28, 1995 

In the United States, AIDS has affected gay men 
more than any other social group. There are spe- 
cial relationships between drug dependency and 

HIV/AIDS. Any discussion of the special needs of 
chemically dependent gay and lesbian persons must 
include the special problems clinicians need to be 
aware of when caring for the HIV-positive patient. 
This article explores HIV disease, including its 
causes, development, transmission, treatments, and 

Substance Abuse Resource Guide 

Coping Strategies, Substance Use, Sexual Activity 
and HIV Sexual Risks in a Sample nf Gay Male SID 

Barrett, D.; Bolan, C; Doll, L; et al. 
journal of Applied Social Psychology, 25:1 058- 

The relationships of coping strategies with levels of 
substance use and sexual activity, and with HIV 
sexual risks, were examined in 416 gay male STD 
clinic patients. The problem-focused strategy (PFS) 
of advice seeking was negatively related to the num- 

ber of types of drugs used and to the number of 
sexual partners. The PFS of support seeking was 
negatively related to the number of days using 
drugs. Use of emotion-focused strategies (EFSs) was 
positively related to the number of types of drugs 
used. PFSs were less directly related to engaging in 
HIV sexual risks when measures of substance use 
and of sexual activity were included in the predic- 
tion; EFSs were more stably related to HIV risk. 
Relationships between coping and levels of sub- 
stance use and sexual activity suggest that these 
activities are used to relieve strain, but that rela- 
tionships between coping and HIV sexual risks in- 
volve less clearly understood direct and indirect 

lesbian Alcohol and Marijuana Use: Correlates ot 
HIV Risk Behaviors and Abusive Relationships 

Perry S.M. 

journal of Psychoactive Drugs, 27(4): 41 3-41 9, 

In response to the dearth of specific information 
about lesbians' health status and practices in the 
health literature, a national study utilizing a self- 
administered questionnaire was conducted in 1 987 
by four associates of the Fenway Community Health 
Center in Boston to access data in these areas. The 
questionnaire solicited information about demo- 
graphics, health practices, stress in personal and 
work lives, mental and physical health problems, 
sexual practices, family history of health-related 
problems, and genetic attributes hypothesized to 
be related to "gayness." Questionnaires from 1 ,633 
lesbian women provided the database for the study. 
This paper discusses the portion of the survey that 

dealt with mental health services and life experi- 
ences. Past studies that investigated mental health 
needs of lesbians focused on the quality of treat- 
ment by mental health providers, rates of suicide 
attempts, and alcoholism. This paper compares 
these past findings with the responses of the lesbi- 
ans in this national, community-based study. Find- 
ings indicate that although a significant number of 
the lesbian women in this sample had been in 
therapy, they sought out therapy as a coping strat- 
egy to deal with similar issues as other women (i.e., 
depression and relationships). Suicide attempts de- 
creased considerably after adolescence and "com- 
ing out." Rates of alcohol use and abuse, although 
difficult to compare with other studies, were higher 
than other women but similar to other studies in- 
vestigating a community sample of lesbians. Even 
with a high family history of alcoholism, less than 5 
percent reported having sought out therapy to deal 
with any issues of alcohol or drug use. 

Prevention Materials for Lesbian, Gay, Bisexual, and Transgender Populations 

Reliance by Gay Men and Intravenous Drug 
Users on Friends and Family for AIDS-Related 

Johnston, D.; Stall, R.; and Smith, K. 
AIDS Care, 7: 307-319, 1995 

A group of gay-identified men (n = 81) and intra- 
venous drug users (IDUs) (n = 88) diagnosed with 
AIDS in San Francisco were interviewed regard- 
ing their use of friends and family to meet their 
care needs. An analysis of quantitative data re- 
vealed that gay men relied more than did IDUs 
on friends for care. Neither group relied prima- 
rily on their families for care. Analysis of the quali- 
tative data identified five primary barriers to care. 
First, many people with AIDS are not accustomed 

to asking for help and often avoid it when possible. 
Second, the social stigma surrounding AIDS some- 
times leads to isolation. Third, some people with 
AIDS have relatives with health problems of their 
own, thereby sometimes compromising this poten- 
tial source of care. Fourth, the AIDS epidemic has 
devastated identifiable sub-populations, leaving sur- 
viving members of these groups emotionally ex- 
hausted and sometimes unable to provide as much 
help as they might have liked. Finally, some respon- 
dents choose to voluntarily cut themselves off from 
"supportive" relationships that they perceive to be 
destructive now that they have been diagnosed with 
a fatal illness. Professional care providers and health 
care planners should be aware of dynamics within 
informal care networks of people with AIDS that 
may leave patients without necessary care. 

Remission of Substance Use Disorders: Gay 
Men in the First Decade of AIDS 

Remien, R.H.; Goetz, R.; et a/. 

Journal of Alcohol Studies, 56(2): 226-232, 1995 

Participants in a 5-year prospective study of HIV- 
seropositive and seronegative gay men demon- 
strated a significant decline in the rate (from life- 
time to current) of alcohol and other DSM-III-R 
psychoactive substance use disorders. The goal 
of the study was to identify factors associated with 
the cessation of problematic substance use, to ob- 
serve rates of relapse over 4 years, and to de- 
scribe factors associated with relapse and no re- 
lapse. A volunteer community sample of self-iden- 
tified gay men (n = 56) were administered a semi- 
structured interview and several self-report mea- 
sures by trained mental health clinicians, twice 

annually over a 5-year period. Retrospective and 
prospective data revealed a significant decline in 
substance use and problems associated with use in 
the decade of the 1980s. This change occurred, 
for the most part, without formal treatment. Nu- 
merous motivating factors were associated with this 
change, which included a fear of AIDS, a change 
in attitudes in the gay community, changes in other 
risk-taking behaviors, and concerns about self-im- 
age. A variety of informal methods were employed. 
Most notable was "avoiding situations associated 
with substance use." Changes in substance abuse- 
dependence occurred in the context of health con- 
cerns, caring for oneself and "cleaning up one's 
act." Having a concern about "self-image," avoid- 
ing situations associated with drug use, and not 
using "drug substitution" as a method of quitting 
were important factors for maintaining successful 


Substance Abuse Resource Guide 

Sexual Orientation and the Addictions 

Cabaj, R - R 

Journal of Cay and Lesbian Psychotherapy, 2(3): 97- 

117, 1995 
Available from The Haworth Press, Inc., 10 Alice 

Street, Binghamton, NY 1 3904-9981 ; 800-342- 


Change and growth are essential parts of human 
development. Sometimes help is needed for 
change necessitating psychotherapeutic interven- 
tions. The desire for some specific changes, how- 
ever, may be based on misunderstanding, fear, or 
prejudice. The therapist must take a clear and ob- 
jective view, understand what motivates the 
change, and not promise the impossible. 

Gay men and lesbians, or people who are begin- 
ning to become aware of a homosexual orienta- 
tion, may wish to try to change that orientation 
based on a combination of internalized and exter- 
nal homophobia. This combination leads to the 
higher expression of the incidence of substance 

abuse among gays and lesbians. The gay and les- 
bian substance abuser that has not been able to 
accept and integrate his or her sexual orientation 
may well seek the help of psychotherapy to change 
orientation, hoping to somehow get life back on 
track. Denial of sexual orientation, however, usu- 
ally extends to denial around issues of substance 
use and abuse. 

Before any real movement can occur in therapy, 
the therapist must help the substance abuser rec- 
ognize the illness of substance abuse and the need 
to have treatment for it. As part of the early recov- 
ery process of getting clean and sober, sexual ori- 
entation must be discussed and ways to accept and 
live with being gay or lesbian explored. After 6 
months of being clean and sober, a patient may be 
in a position to effectively utilize psychotherapy to 
explore and resolve internalized homophobia. Usu- 
ally, the desire to change sexual orientation subse- 
quently disappears, and the patient learns how to 
fully accept and integrate a gay or lesbian identity 
into their newly found sobriety. 

Spiritual Exiles in Their Own Homelands: Gays, 
Lesbians and Native Americans 

Tafoya, 1; Roeder, K.R. 

Journal of Chemical Dependency Treatment, 5(2): 

Clinical considerations and comparisons are ex- 
plored in direct relation to the role of spirituality in 
recovery for gays, lesbians, and Native Americans 

with an emphasis on American Indians and Alas- 
kan Natives. The authors examine the development 
stages of identity, common prejudices experienced 
by these minority groups, the influence of Chris- 
tianity and the role of the church and synagogue, 
alcohol incidence rates, and the historical context 
of 'exile' from homeland. Comparisons occur 
among these groups which could aid the worker in 
a greater understanding of this clientele, thus di- 
rectly impacting the success of client/worker con- 
tact in the recovery and healing process. 

Prevention Materials for Lesbian, Gay, Bisexual, and Transgender Populations 


A Comparison of Public Health Care Utilization 
hi Gay Men anil Intravenous Drug Users with 
AIDS in San Francisco 

Johnston, D.; Smith, K.; and Stall, R. 
AIDS Care, 6: 303-316, 1994 

A group of gay-identified men (n = 81 ) and intra- 
venous drug users (n = 88) diagnosed with AIDS 
in San Francisco were surveyed regarding their 
use and satisfaction with their health care services. 
The interview contained a mix of qualitative and 
quantitative questions. The two groups of AIDS 

patients were not statistically different in terms of 
age or self-reported level of health during the pre- 
vious 3 months, although the gay men had been 
diagnosed with AIDS somewhat longer (20 months) 
than the group of intravenous drug users (15 
months). Analysis of the quantitative data revealed 
that intravenous drug users receive more medical 
care for HIV disease than did gay men and were 
equally satisfied with the care that they did receive. 
Analysis of the qualitative data showed that con- 
siderable agreement exists between the percep- 
tions of both gay men and intravenous drug users 
of the health care system. 

Correlates of Sexual Risk-Taking Among Gay 
Male Suhstance Ahusers 

Paul, ).; Stall, R.; Crosby, CM.; et al. 
Addiction, 89: 971-983, 1994 
Available from Carfax Publishing Corporation, 
Abingdon, Oxfordshire OX1 3 3UE England 

This paper examines sexual risk-taking within a 
sample of sexually active gay and bisexual men 
entering substance abuse treatment (n — 383), 
and identifies correlates of unprotected anal sex 
within this group. Sexual risk-taking was high, with 
55 percent of these men engaging in anal inter- 
course without a condom within a 90-day pe- 

Correlates of unprotected anal sex varied some- 
what when looking at unprotected anal sex with 
a primary partner only. With non-primary part- 
ners; substance use variables (number of drugs 
used, use of inhalant nitrites or stimulant drugs 
with sex, length of time since use of alcohol/drugs, 

loss of control problems associated with alcohol/ 
drug use) appear to play more of a role in unpro- 
tected anal sex with non-primary partners. Over- 
all, logistic regression analyses indicated that sexual 
risk was greater for those who were more sexually 
active, enjoyed unprotected anal sex with with- 
drawal prior to ejaculation, did not approve of sex 
outside of a love relationship, and identified them- 
selves as more risky. 

In addition, those who reported more social prob- 
lems due to substance use had fewer expectations 
that substance use increased risk. Moreover, this 
group had been HIV-tested, and their use of reap- 
praisal/problem-solving coping strategies showed 
greater risk with a primary partner only. Sexual risk 
with non-primary partners was greater for those 
who used more drugs, reported more difficulty 
avoiding high-risk sex when aroused and were HIV 
positive. The paper discusses the implications of 
these findings for the design of sexual risk-reduc- 
tion interventions. 

Substance Abuse Resource Guide 

The Prevalence and Demographic Predictors of 
Illicit and Licit Drug Dse Among Lesbians and Gay 


Skinner, W.F. 

American Journal of Public Health, 84(8): 1 307- 
1310, August 1994 

Studies on illicit and licit drug use among homo- 
sexuals of both sexes have focused primarily on 
gay men, used limited drug measures, and been 

conducted in cities known for large homosexual 
populations. This paper examines (1) the preva- 
lence of 12 illicit and licit drugs by sex and age 
group, and (2) the demographic predictors of past- 
year frequency of marijuana, alcohol, and cigarette 
use. Organizational mailing lists were used to col- 
lect self-report data on 455 homosexuals living in 
a southern State. Differences were found between 
gay men and lesbians in the use of specific sub- 
stances and in the demographic predictors of drug 

Research on Lesbians and Alcohol: Gaps and 

Hughes, 11. 

Alcohol Health and Research World, 18(3): 202- 

Available from Progressive Research and Training 
for Action; Lesbian, Gay, and Transgender Tech- 
nical Assistance Project, 440 Grand Avenue, 
Suite 401 , Oakland, CA 9461 0-501 2; 51 0-465- 

This article discusses the prevalence of lesbian al- 
cohol use and abuse and risk factors for lesbians' 
drinking behavior, including employment and mul- 
tiple roles. It also gives future perspectives. 

Verhal and Physical Abuse as Stressors in the 
Lives nf Lesbian, Gay Male, and Bisexual Youths. 
Assnciatinns with Schnul Problems, Running 
Away, Substance Abuse, Prostitution, and Suicide 

Savin-Willliams, R.C. 

Journal of Consulting and Clinical Psychology, 62(2): 

This article examines the role of verbal and physi- 
cal abuse as stressors that increase risk for several 
problematic outcomes among gay, lesbian, and bi- 
sexual youth, including association with substance 

Prevention Materials for Lesbian, Gay, Bisexual, and Transgender Populations 

A Comparison of Alcohol Consumption Between 
lesbians and Heterosexual Women in an Urban 

Bloomfield, K. 

Drug and Alcohol Dependence, 33: 257-269, 

An elevated rate of alcohol problems is believed 
to exist in the gay and lesbian community. How- 
ever, prevalence estimates suggesting this have 
generally been based on convenience samples, 
which have over-represented bar patrons and 

clinical sources. Recent epidemiological studies ex- 
amining risk factors for AIDS have gathered infor- 
mation on alcohol consumption as well as sexual 
orientation. Data based on improved sampling 
methods are now available for estimating drinking 
rates of lesbians and gay men. This study compares 
the drinking patterns of heterosexual women and 
lesbian/bisexual women who were recruited 
through a random sampling design in San Francisco, 
CA. Contrary to previous research, no statistically 
significant differences in alcohol consumption and 
drinking patterns between these two groups were 

Risk Factors for Attempted Suicide in Gay and 
Bisexual Youth 

Remafedi, C; Farrow, J A.; et al. 
Pediatrics, 87(6): 869-875, 1991 

Studies of human sexuality have noted high rates 
of suicide among homosexual youth, but the prob- 
lem has not been systematically examined. This 
work was undertaken to identify risk factors for 
suicide attempts among bisexual and homosexual 
male youth. Subjects were 137 gay and bisexual 
males, 14 through 21 years of age, from the up- 
per Midwest and Pacific Northwest. Forty-one 

subjects (41/137) reported a suicide attempt, and 
almost half of them described multiple attempts. 
Twenty-one percent of all attempts resulted in 
medical or psychiatric admissions. Compared with 
non-attempters, attempters had more feminine 
gender roles and adopted a bisexual or homosexual 
identity at younger ages. Attempters were more 
likely than peers to report sexual abuse, drug abuse, 
and arrests for misconduct. The findings parallel 
previous studies' results and also introduce novel 
suicide risk factors related to gender nonconfor- 
mity and sexual milestones. 


National Pnlicy Ayenda nn HIV/AIDS and 


Legal Action Center, Washington, DC, 1997 

A National Policy Agenda is proposed based on 
the fact that national HIV/AIDS policies and strat- 
egies have largely ignored the prevalence trends 
of risk for HIV/AIDS caused by shared needles, 
having sexual contact with someone infected by 
drug use, or engaging in high risk sexual activity 
while under the influence of alcohol or drugs. 

Funding and policy recommendations are made. 
Recommendations with regards to substance abuse 
treatment include: funding of substance abuse 
treatment and a prevention block grant of $1 .5 bil- 
lion to increase availability of drug and alcohol pre- 
vention and treatment; ensure that funding for 
school-based alcohol and drug prevention efforts 
supports programs that have demonstrated effec- 
tiveness in reducing alcohol and drug use that ad- 
dress prevention of HIV disease; and, expand Med- 
icaid reimbursement for drug and alcohol treat- 


Substance Abuse Resource Guide 

Alcohol Marketing to the Cay Community 

Rahn, P. 

Prevention Pipeline, 7(6): 30-31, November/ 

December 1994 
Available from SAMHSA's National Clearinghouse 

for Alcohol and Drug Information, RO. Box 

2345, Rockville, MD 208470-2345; 800-729- 


This article explores the alcohol industry's mar- 
keting efforts to gay and lesbian organizations and 

events, including gay-owned beer companies. Con- 
cerns are raised about the contradictions in alco- 
hol marketing and underwriting for events, and the 
impact of alcoholism in the gay and lesbian com- 
munity. Moreover, some studies reveal that 40 
percent of gay men who engaged in unsafe sex said 
alcohol use precipitated their behavior. This sup- 
ports research that reveals links between alcohol 
use and impaired cognitive skills, as well as break- 
ing down the body's immune system to fight HIV 
and other infections. 

Gay and Lesbian Youth: Challenging the Policy of 

Taylor, N. 

journal of Gay and Lesbian Social Services, 1 (3/ 
4): 39-73, 1994 

The author recommends the development of poli- 
cies to address the needs of lesbian, gay, bisexual, 
and transgender (LGBT) youth. Among a myriad 
of problems, these policies would provide sup- 
port to LGBT youth and address the issues of in- 
visibility in the larger society, LGBT youths as tar- 
gets of the religious right, and institutionalized ho- 

mophobia. Taylor proposes policy changes that 
would create a healthier environment for LGBT 
youth; development of curricula, programs, and 
specialized services for LGBT youth and their fami- 
lies; funding for shelters and foster care; and "ef- 
forts to end codified discrimination in agencies that 
serve youth." The author also examines the early 
history of LGBT organizations and their reluctance 
to focus outreach efforts on youth because of their 
fear of child abuse accusations and/or the fallacy 
of "recruiting" young people. However, the increas- 
ing growth of LGBT organizations and the open- 
ness of society have significantly diminished those 

Leshians and Gays Face Tohacco Targeting 

Goebel, K. 

Prevention Pipeline, 7(6): 105-107, November/ 
December 1994 

Available from SAMHSA's National Clearinghouse 
for Alcohol and Drug Information, RO. Box 
2345, Rockville, MD 20847; 800-729-6686 

Th is article exam i nes how tobacco com pan ies tar- 
get lesbian and gay smokers. It posits that lesbi- 
ans and gays are brand loyal, have high discre- 

tionary incomes, and smoke at extremely high rates. 
In a 1984 study, 41.8 percent of gay men were 
smokers; another study found that 25 percent of 
lesbians were smokers. The pressures that result in 
teenage smoking — self-esteem issues and the need 
for peer acceptance, the need for rebellion and 
liberation, the development of style and individu- 
ality — are compounded for lesbians, bisexuals, and 
gay men struggling with their sexuality. The article 
discusses how Philip Morris markets Benson & 
Hedges, Virginia Slims, and Marlboro to lesbians 
and gay men. 

Prevention Materials for Lesbian, Gay, Bisexual, and Transgender Populations 


A Pacific Perspective: Prevention Through 
Managed Care Health Systems 

Barlow, J.W. 

National Lesbian and Gay Health Association An- 
nual Conference, 1998 

This paper was presented at the 1 998 Annual Con- 
ference of the National Lesbian and Gay Health 
Association in San Francisco, CA. The paper pro- 
vides an overview of alcohol, tobacco, and drugs 

(ATD) prevention for lesbian and gay populations 
in the Pacific Basin. The cultural issues specific to 
this population are presented and variations are 
pointed out amongst the Pacific Basin island states. 
Lesbians and gays are often "considered special 
and given very high rank and responsibility in tra- 
ditional island cultures." Recommendations are 
made for collaboration and infrastructure design 
for partnering to provide prevention and health 
care services for the lesbian and gay populations. 

Lesbian, Bay and Bisexual Health in Cross- 
cultural Perspective 

Silenzio, V.M.B. 

Journal of the Gay and Lesbian Medical Associa- 
tion, 1(2): 75-86, 1997 

Health care services for lesbians, gay men, bisexu- 
als, and others are profoundly influenced by social 
and cultural factors, and appreciation of these fac- 
tors plays an important role in understanding the 
patterns of health and disease in these populations. 
Concerned individuals and providers of health care 
to lesbian, gay, bisexual, and transgender (LGBT) 
individuals and populations can benefit greatly from 
anthropological insights into the health concerns 
of these populations, and into the limits of our con- 
ceptual frameworks of human sexuality and the 

forms of (LGBT) cultures. Western cultural norms 
and interpretations of same-sex phenomena should 
be applied to other cultures, both at home and 
abroad, with caution. In light of the degree to which 
our schemata of human sexuality are culturally 
bound, practitioners may utilize the concepts of 
cultural sensitivity and cultural competence to re- 
main sensitive to an individual's identity with and 
connectedness to his or her subcultures, and at- 
tempt to gain competence in providing care to 
members of these subcultures. Sociocultural fac- 
tors are also important considerations for primary, 
secondary, and tertiary health interventions aimed 
at (LGBT) individuals, as well as health and social 
policy activities for health care providers, activists, 
advocates, educators, policy makers, and the gen- 
eral public. 

A Comprehensive Care nf leshian and Gay Pa- 
tients and Families 

Harrison, A.E.; Silzenzio, V.M.B. 
Primary Care, 23(1): 31-45, 1996 

The unique health care needs of gay and lesbian 
patients and their families are often ignored. This 
article reviews the literature on the health care 
needs of gay men, lesbians, and their families and 
offers ways that primary care of these individuals 
can be improved. Traditionally, practitioners have 

assumed that patients' sexual orientation does not 
affect their health care. Insofar as health is "a state 
of complete physical, mental, emotional, and so- 
cial well-being, and not merely the absence of dis- 
ease or infirmity," however, sexual orientation 
clearly affects it. Furthermore, research shows that 
the patient-physician relationship is a critical fac- 
tor in the patient's well-being. It can be vitally 
important in the patient's physiological and psy- 
chological responses to therapy, compliance with 
medical advice, and overall satisfaction with treat- 
ment and care received. 

Substance Abuse Resource Guide 

"Alive with Pleasure. . ." Conference Proceed- 
ings, Final Report 

Drabble, L; Soliz, G. 

Presented at "Alive with Pleasure: Prevention of 
Tobacco and Alcohol Problems in Lesbian, 
Gay, Bisexual, and Transgender Communi- 
ties," October 3-4, 1996, San Francisco, CA 

Available from Progressive Research and Train- 
ing for Action; Lesbian, Gay, and Transgender 
Technical Assistance Project, 440 Grand Av- 
enue, Suite 401 , Oakland, CA 9461 0-501 2; 

Funded by the Center for Substance Abuse Pre- 
vention, this report summarizes proceedings and 
recommendations from a regional conference on 
alcohol and tobacco prevention in lesbian, gay, bi- 
sexual, and transgender (LGBT) communities. A sig- 
nificant part of the report examines 1 5 case stud- 
ies documenting a broad range of community- 
based prevention strategies that have been imple- 
mented to address both environmental and indi- 
vidual factors related to tobacco and alcohol prob- 
lems in LGBT communities. These cases provide 
ideas and lessons that may be instructive for indi- 
viduals and organizations interested in advancing 
prevention efforts in their own LGBT communi- 

Issues in Psychotherapy with HIV-infected 
latinns in New York City 

Millan, E; Caban, M. 

Journal of Social Distress and the Homeless, 5(1 ): 

This article describes some of the issues that arise 
in psychotherapy with Latino HIV-infected pa- 
tients and their caregivers, and utilizes the Model 
of Multiple Oppression (MMO) to organize the 
issues discussed. The case of an HIV positive, 
alcoholic, gay Latino man with a history of being 
sexually abused is discussed to illustrate how in- 
formation from the MMO can be used clinically. 
Stigmatization by racial or ethnic backgrounds is 
often influential in how one approaches treat- 
ment. Among Latinos, language, gender role ex- 
pectations and family expectations are additional 
factors that affect Latino men in finding support 

and communicating needs. Many men, feeling in- 
secure and disrespected, turn to the use of alcohol 
or drugs or leave the family causing women to raise 
children alone. In the case illustrated, the homo- 
sexual orientation of the individual is a dynamic 
factor in self-guilt and lack of family support. The 
risk categories of homosexual sex and homosexual 
sex plus injecting drug use account for 36 percent 
of the total Latino patients regarding their sexual 
identity. Patients also report feeling discrimination, 
based on their ethnic identity, from gay organiza- 
tions run by gay white men. This study demon- 
strates the use of the MMO in psychotherapy with 
multiple oppressed HIV-infected Latino patients. 
It describes not only AIDS issues, but also on the 
impact of environmental factors such as poverty, 
employment and family issues on the subsequent 
intrapsychic processes and behavioral/clinical mani- 

Prevention Materials for Lesbian, Gay, Bisexual, and Transgender Populations 


Why and How You Should Form a Gay and Lesbian 
AIDD Prevention Program in Your Community 

Baker, J. 

Prevention Pipeline, 7(6): 21-23, November/ 

December 1994 
Available from SAMHSA's National Clearinghouse 

for Alcohol and Drug Information, RO. Box 

2345, Rockville, MD 20847-2345; 800-729- 


The author notes several reasons why gay and 
lesbian alcohol and drugs prevention programs 
are needed, including the presence of significant 
percentages of lesbian, gay, bisexual, and 
transgender (LGBT) persons in the population, the 
added challenges experienced by adolescent gay 

youth, and the links between HIV/AIDS and drugs 
and alcohol. In fact, Baker points out the fact that 
most people who have had HIV/AIDS for 10 years 
or more attribute their survival and viability to elimi- 
nating alcohol and drugs in their diet during the 
early stages of the infection. The author suggests 
ways to develop LGBT-specific alcohol and drug 
prevention programs including: enlist the assistance 
of gay community organizations and centers, seek 
out gay leaders who can help, work with current 
social service providers in the gay community to 
develop and implement a prevention program, and 
target gay news organizations as well as cultural or- 
ganizations. In fact, many cultural and ethnic-based 
organizations have gay constituents, whether ac- 
knowledged or not. 

Sexual Diversity in Alcohol and Other Druy 
Ahuse Preventioo 

Eversole, T. 

Prevention Pipeline, 7(6): 95-99, November/De- 
cember 1994 

Available from SAMHSA's National Clearinghouse 
for Alcohol and Drug Information, RO. Box 
2345, Rockville, MD 20847-2345; 800-729- 

This article addresses alcohol and drug abuse 
among lesbians and gays and risk factors confront- 
ing lesbian, gay, and bisexual youths and adults in- 
cluding overcoming school risk factors, providing 
healthy role models, and understanding family risk 

Substance Use and Risky Sexual Behavior for 
Exposure tu HIV: Issues in Methodology, Inter- 
pretation and Preventinn 

Leigh, B.; Stall, R. 

American Psychologist, 48: 1035-1045, 1993 

Recent reports have suggested that the use of al- 
cohol or drugs is related to sexual behavior that is 
high risk for HIV infection. If substance use leads 
to unsafe sexual activity, understanding the dy- 
namics of this relationship can contribute to re- 
search and preventive and educational efforts to 

contain the spread of AIDS. This article reviews re- 
search on the relationship between substance use 
and high-risk sexual behavior. The article then con- 
siders the inherent limitations of the research de- 
signs used to study this relationship, outlines some 
methodological concerns including measurement 
and sampling issues, and comments on causal in- 
terpretations of correctional research findings. A 
consideration of potential avenues for future re- 
search and a discussion of implications of these find- 
ings for current AIDS prevention policies are also 

Substance Abuse Resource Guide 


Additional Methadone Increases Craving for 
Heroin: A double-blind, Placebo-controlled Study 
of Chronic Opiate Users Receiving Methadone 
Substitution Treatment 

Curran, H.V. 

Addiction, 94(5): 665-674, 1999 

Available from Carfax Publishing Limited, RO. 

Box 25, Abingdon, Oxfordshire, OX14 3UE, 

United Kingdom 

The aim of this study is to assess the acute-on- 
chronic effects of methadone on drug craving, 
mood and cognitive and psychomotor function- 
ing in patients on long-term methadone substitu- 

tion treatment. A double-blind, cross-over design 
was used to compare the effects of a 33 percent 
increase in patient's daily dosage of methadone 
with a matched placebo linctus. Eighteen patients 
completed the study and all were assessed pre- and 
post-drugs on two separate testing days. Metha- 
done significantly increased both positive craving 
(expected positive effects) and negative craving (ex- 
pected relief of withdrawal discomfort) for heroin. 
Patients were unable to distinguish between metha- 
done and placebo treatments. No differences be- 
tween treatments emerged in cognitive or psycho- 
motor effects. In terms of mood, patients were more 
alert and more contended following placebo than 
following methadone. Researchers found addi- 
tional methadone may "prime" heroin cravings. 

Adolescent Homosexuality 

Stronski-Huwiler, S.M.; Remafedi, C. 
Advanced Pediatrics, 45: 107-144, 1998 

Homosexuality has existed in all civilizations, but 
societal disapproval and cultural taboos have 
negatively influenced its recognition. A significant 
percentage of youths identify themselves as ho- 
mosexual, and even more experience sex with 
the same sex or are confused about sexual feel- 
ings. A unifying etiological theory attributes the 
expression of sexual orientation to genes that 
shape the central nervous system's development, 
organization, and structure via prenatal sex ste- 
roids. Environmental factors may influence the ex- 
pression of genetic potential. Several models of 
psychosocial development describe initial stages 
of awareness and confusion about same-sex at- 

tractions, followed by acknowledgment of homo- 
sexuality, disclosure to others, and eventual inte- 
gration of sexual identity into a comprehensive 
sense of self. Stressors related to isolation, stigma, 
and violence may predispose homosexual adoles- 
cents to impaired social, emotional, and physical 
health, resulting in depression and suicide, school 
problems, substance abuse, running away, eating 
disorders, risky sexual behavior, and illegal conduct. 
As with all adolescents, the overall goals in the care 
of homosexual youth are to promote normal ado- 
lescent development, social and emotional well be- 
ing, and physical health. A comprehensive, 
multidisciplinary approach is required to address 
medical, mental health, and psychosocial issues 
within the context of the adolescents' community 
and culture. 

Prevention Materials for Lesbian, Gay, Bisexual, and Transgender Populations 

Caring for Gay and Lesbian hens 

Ryan, C; Futterman, D. 

Contemporary Pediatrics, November 1998, pp. 

An overview of issues and strategies for working 
with gay and lesbian teens are provided in this ar- 

ticle. The authors differentiate between sexual be- 
havior and sexual orientation. When working with 
adolescents they suggest: creating a supportive en- 
vironment; providing anticipatory guidance; coun- 
seling techniques and areas; and, making referrals. 
Also included is a suggested reading list for practi- 

Substance Abuse and HIV Diseases: Entwined and 
Intimate Entities 

Cabaj, R.R 

In E.F. McKance-Kutz and T.R. Kusten, New Treat- 
ments for Chemical Addictions. Washington, 
DC: American Psychiatric Press, 1 998, pp. 1 1 3- 

This chapter presents the issues around comorbidity 
of substance abuse and HIV, including IV drug use 

and high-risk sexual behaviors. Presented are the 
epidemiology; cofactors of high-risk sexual behav- 
iors and substance abuse; women; and socioeco- 
nomic factors. The author then suggests preven- 
tion, intervention, assessment, treatment, and 
medical management for HIV-infected substance 
abusers. Additionally, psychopharmacology, 
suicidality, psychotherapy, gay and bisexual men, 
youth, women and children, and people of color 
are addressed as special populations. 

Ihe Iransgender Experience: identity, Community 
and Recovery 

Warren, B.E. 

The Counselor, May/June 1 997, pp. 1 6-1 8 
Available from the National Association of Alco- 
holism and Drug Abuse Counselors (NAADAC), 
1 91 1 North Fort Myer Drive, Suite 900, Arling- 
ton, VA 22209; 703-741-7686; 800-548-0497 

The author provides an overview of what it means 
to be a transgender person, including self defini- 
tion based on physiology versus self-identification, 
and how the person feels he or she is compelled to 
express the feminine or masculine side of self. The 
suggestion thattransgenderism emerges from child- 
hood is discussed, in that some theorists believe 
the transgender person either "insufficiently iden- 

tifies" with the same sex parent or there is "over- 
identification" with the opposite sex parent. The 
author points out that transgender persons have 
benefited greatly from therapy that "emphasizes 
exploration and affirmation of self-identity." As gay, 
lesbian, and bisexual people do, many transgender 
persons feel assimilation into the mainstream of 
society is essential. Yet, many live a closeted life 
and grapple with shame and depression. For many, 
this leads to substance abuse. The author notes that 
"although there is no research to support the no- 
tion that transgender persons may be at higher risk 
for substance abuse, there is anecdotal evidence." 
Also, evidence is cited that transgender persons 
are at higher risk for HIV/AIDS because of unsafe 
sex, intravenous drugs, and needle sharing. More- 
over, it is noted that HIV education does not focus 
on the transgender community. 

Substance Abuse Resource Guide 

Barriers to Accessibility for Lesbian and Gay 
Youth Needing Addiction Services 

Travers, R. 

Youth & Society, 27(3): 356-378, 1996 

Using a qualitative research method, this study 
investigates the ways in which homophobia and 
heterosexism constitute barriers to treatment for 
lesbian and gay youth in need of addiction ser- 

vices. Seventeen lesbian and gay youth were in- 
terviewed regarding their experiences in addiction 
services. The major barriers that they report in- 
clude marginalization, avoidance of gay and les- 
bian issues, ignoring sexual orientation as an issue, 
deflection and contradiction, outing, harassment, 
early discharge, and misinformed staff. Recommen- 
dations are made for making addiction services 
more appropriate and accessible for lesbian and 
gay youth. 

Building Alliances, Protectiog Diversity, and 
Uniting for Health Care 

Abbott, L.J.; Kennedy N.J. 
Paper presented at the National Lesbian and Gay 
Health Conference, Seattle, WA, July 1 3, 1 996 

Addictive diseases, including alcoholism, do not 
have a long standing and comprehensive history 
within the traditional health care system, making 
systematic and accurate reporting and analysis 
problematic. Often primary practitioners, depend- 
ing upon demographic and other client factors, 
ignore the risk factors associated with alcohol 
abuse and alcoholism. That same misdiagnosis 

also occurs with childhood depression, conduct dis- 
orders, and other emotional problems. The dual 
failure often results in later onset of co-occurring 
disorders. Although the National Association of 
Lesbian and Gay Addiction Professionals (NALGAP) 
has been advocating for a minimum of 13 years, 
there has been no national-probability-based sur- 
vey of the lesbian community regarding their alco- 
hol, tobacco, and drug use, abuse, and/or addic- 
tion or the inclusion of sexual orientation questions 
within existing national probability surveys. This 
panel presented substance abuse treatment issues 
for gay, lesbian, and bisexual individuals and a pro- 
posed list of questions for consumers of treatment 


Prevention Materials for Lesbian, Gay, Bisexual, and Transgender Populations 


longitudinal Changes in Alcohol and Drug Use 
Among Men Seen at a Gay-Specific Substance 
Abuse Treatment Agency 

Paul,}.?.; Barrett, D.C.; Crosby, CM.; and Stall, R.D. 
Journal of Studies on Alcohol, 57: 475-485, 1 996 

This study describes changes over a 1 2-month pe- 
riod in prevalence and frequency of alcohol and 
drug use and correlates of change at 1 2 months in 
a sample of gay/bisexual men entering gay-identi- 
fied outpatient substance abuse treatment. A se- 
quential sample of gay/bisexual men (n = 455) were 
recruited for a study in which substance use, sexual 
risk and psychological factors were assessed every 
3 months. Changes in substance use were evalu- 
ated in 321 men who used in the 90 days before 
entering treatment and who completed at least one 
follow-up interview, whether or not they contin- 
ued in treatment. 

At baseline, 95 percent of the sample reported al- 
cohol use in the prior 90 days, 64 percent — mari- 
juana/hashish use, 46 percent — amphetamine use; 
33 percent — inhalant nitrites use, and 31 percent — 
cocaine use. Most men were polydrug users: 10 
percent reported using only one drug (including 
alcohol); 39 percent used at least four drugs. A 
marked reduction occurred in prevalence of use 
over time, and declines of 50 percent occurred in 
the first 90 days. Prevalence then stabilized in the 
remaining assessments. Frequency of usage by 
those reporting use of any given class of drugs also 
declined. No consistent predictors of reduction or 
cessation of use across different drug categories 
were found at 1 year. 

Substance use declined considerably in this sample. 
Given the scope of substance abuse problems 
among gay/bisexual men, and linkages to the HIV 
epidemic, considerable resources need to be fo- 
cused on treatment and prevention for gay/bisexual 

Sexual Minurities and Substance Abuse Treat- 
ment: Selected Bibliographies: 1990-1996 

Calibur Associates 

Rockville, MD: National Evaluation Data and Tech- 
nical Assistance Center (NEDTAC), Center for 
Substance Abuse Treatment (CSAT) 

A primary NEDTAC activity was to provide evalua- 
tion technical assistance and support to substance 
abuse treatment providers and evaluators. To this 
end, NEDTAC produced a series of bibliographies 
in key topic areas. This document belongs to that 
series. This selected bibliography lists books, ar- 
ticles, and research studies that focus on the par- 
ticular issues of sexual minorities in substance abuse 
treatment programs. This document also includes 
a list of support organizations for sexual minorities. 


Substance Abuse Resource Guide 

Substance Abuse and Dependency in Gay Men 
and lesbians 

Anderson, S.C. 

In K.J. Peterson, Health Care for Lesbians and 
Gay Men: Confronting Homophobia and 
Heterosexism , Binghampton, NY: Haworth 
Press, 1996, pp. 59-77 

Research on the incidence, etiology, and treat- 
ment needs of gay men and lesbians who abuse 
alcohol and drugs is limited. Recent studies chal- 

lenge earlier beliefs that the incidence of substance 
abuse is higher among gay men and lesbians than 
in the general population. However, a substantial 
number of this population drink problematically. 
This article reviews the literature on the etiology of 
substance abuse among gay men and lesbians, and 
details important assessment and treatment issues 
unique to this population. The strengths and limi- 
tations of gay-specific treatment programs are dis- 
cussed. Recommendations are made about how 
social workers can respond more appropriately to 
their gay and lesbian clients. 

Lesbian and Gay Youth: Treatment Issues 

Fleisher, J.; Fit I man, J. 

The Counselor, January/February 1995, pp. 27- 

It is contended that, in dealing with lesbian and 
gay clients, the alcoholism and drug abuse coun- 
selor must help them deal with their sexuality and 
help them develop positive self-esteem if they are 
to overcome their substance abuse problem. Gay 
and lesbian youth must deal with the added road- 
blocks of homophobia. Role models also might 
be hard to find. The effect of all of these road- 
blocks, frustrations, and lack of information on 

gay youths ranges from mild confusion, shyness, 
and insecurity to self-hatred, withdrawal, and an- 
ger. Fear of rejection by peers and family mem- 
bers, verbal and physical assaults, and exposure that 
could mar or even ruin their futures leads many of 
these youth to indulge in alcohol and drugs as a 
way to hide from their problems or attempt to fit in 
with their peers. To help gay teens, the counselor 
first needs to identify these clients; this can be 
helped along if the counselor is alert to certain high- 
risk behaviors, such as homelessness and prostitu- 
tion. The latter actions put the gay adolescent at 
high risk for numerous health problems, particu- 
larly sexually transmitted diseases, including HIV 
infection and AIDS. 

Lesbian Health Issues for the Primary Care 

Rankow, EJ. 

Journal of Family Practice, 40(5): 486-496, 1995 

Lesbians have unique health concerns that often 
go unaddressed in a medical setting that assumes 

heterosexuality. These may include cancer screen- 
ing, sexually transmitted diseases, human immu- 
nodeficiency virus (HIV), depression, substance 
abuse, relationship issues, pregnancy, and 
parenting. Awareness of the barriers faced by les- 
bians seeking care, and an inclusive approach to 
the patient will allow primary care providers to be 
more effective in their interactions with all patients. 

Prevention Materials for Lesbian, Gay, Bisexual, and Transgender Populations 


Referrals and Resources for Chemically Depen- 
dent Gay and Lesbian Clients 

Kus, R.J.; Smith, G.B. 

Journal of Gay and Lesbian Social Services, 2(1 ): 

Alcoholism and other forms of chemical depen- 
dency have the potential to cause havoc in all 
realms of life. Not surprisingly, then, recovering 
persons and their loved ones often need a myriad 
of resources. In addition to the resources that would 
likely be needed by any recovering persons, gay 
and lesbian persons often need resources specific 

to their needs as gays and lesbians. Many social 
workers and other helping professionals, however, 
do not know how to go about finding out what gay 
and lesbian resources are available to them, and 
therefore they are unable to make needed refer- 
rals for such clients. The purpose of this article is to 
discuss some of the unique problems which gay 
and lesbian recovering persons and their loved ones 
may have which might necessitate referrals, how 
to decide whether one should treat or refer, some 
basic resources that may be available to helping 
professionals to meet these specific gay and/or les- 
bians needs, and how to go about finding out what 
is available in one's community. 

Treatment for HIV-infected Alcohol and Other 
Drug Abusers — Treatment Improvement Protocol 
(TIP] Series 15 

Center for Substance Abuse Treatment (CSAT), 1 71 

pp, 1995 
Available from SAMHSA's National Clearinghouse 

for Alcohol and Drug Information, RO. Box 

2345, Rockville, MD 20847-2345; 800-729- 


All HIV-infected substance abusers, regardless of 
the setting in which they receive care, should have 
available to them a spectrum of core services and 
treatment approaches. This TIP identifies these nec- 
essary core services and approaches. It also pro- 
vides recommendations and guidelines for quality 
care for substance abusers in treatment who are 
infected with HIV. 

The Experiences of Lesbians in Alcoholics Anony- 

Hall, J.M. 

Western Journal of Nursing Research, 1 6(5): 556- 

A feminist ethnographic study of lesbians' experi- 
ences in recovery from alcohol problems was done 
to understand from their perspectives how they 
identified alcohol use as problematic, sought help, 
experienced health care interactions and partici- 
pation in Alcoholics Anonymous (AA), and main- 
tained recovery. Through community-based pur- 
posive sampling in San Francisco, 35 lesbians re- 

covering from alcohol problems participated in 
semistructured ethnographic interviews of 2 hours 
duration, which were subsequently interpreted us- 
ing ethnographic coding, narrative analysis, and 
matrix analysis. A major finding was that participa- 
tion in AA was fraught with tension in three areas. 
Each tension was defined by two poles of experi- 
ence that appear to be in conflict. They were as- 
similation versus differentiation, authority versus 
autonomy, and false consciousness versus 
politicization. These tensions are elaborated and 
supported by examples from the women's inter- 
views. Nursing implications regarding the role of 
AA in recovery for marginalized women are dis- 

Substance Abuse Resource Guide 

Lesbians Recovering from Alcohol Problems: In 
Ethnographic Study of Health Care Experiences 

Hall, J.M. 

Nursing Research, 43(4): 238-244, 1994 

The findings of this ethnographic study of 35 San 
Francisco lesbians in long-term alcohol recovery 
describe their identification of alcohol problems, 
help-seeking experiences, and barriers to recov- 
ery in health care interactions. Multiple addic- 
tions and "core difficulties," such as childhood 
trauma, were common yet poorly addressed by 
health care providers. Lesbian clients mistrusted 
culturally ignorant providers who often inappro- 

priately reversed therapeutic roles. Provider-client 
conceptual incongruence about alcohol problems 
often impeded recovery, while providers' persua- 
sive styles (paternalistic, maternalistic, confronta- 
tional, and influential) were pivotal to recovery. The 
confrontation approach caused the most problems. 
It could precipitate crises, be interpreted by the 
women as social ostracism, and retraumatize those 
who had histories of childhood trauma. Consensus 
favored the influential style, characterized by flex- 
ibility, negotiation, support, and avoidance of ulti- 
matums. Conclusions challenge the assumptions 
that alcoholics are manipulative, "in denial," and 
require coercion to attain and maintain recovery. 

An Explnratioo of lesbians 9 Images of Recovery 
from Alcohol Problems 

Hall, J.M. 

P. Noerager Stern (editor), Lesbian Health: What 

are the Issues? Washington, DC: Taylor & 

Francis, 1993, pp. 91-108 

The author attempts to explore the images lesbi- 
ans use to describe their recovery from alcohol 
problems and to derive from this relevant impli- 
cations for health care. Lesbians' experiences in 
recovery are particularly significant because of 
growing concerns about the prevalence of alco- 
hol problems among lesbians, the vulnerability of 

lesbians as an aggregate, and the cultural trend away 
from substance use in lesbian communities. Images 
of recovery are the descriptions that people offer 
about their healing from alcohol problems. They 
are the frameworks by which problem drinkers in- 
terpret the meanings of their experiences and de- 
termine which aspects of their lives are most perti- 
nent to their recovery efforts. The images persons 
use to represent their progress and the difficulties 
they encounter in recovery also provide important 
bases for developing relevant resources, therapeu- 
tic techniques, and social support. Excerpts from 
an ongoing ethnographic interview study about the 
recovery experiences of lesbians with alcohol prob- 
lems illustrate the diversity of recovery images that 
are characteristic of this population. 

Lesbians and HIV: Clinical, Research and Policy 

Stevens, RE. 

American Journal of Orthopsychiatry , 63(2): 289- 

Sources of risk for HIV infection in members of the 
lesbian community are surveyed, together with fac- 
tors that adversely affect access to appropriate 
health care by women in general and lesbians in 
particular. Issues of clinical practice, research, and 
public policy are examined with a view of promot- 
ing more effective prevention and treatment strat- 

Prevention Materials for Lesbian, Gay, Bisexual, and Transgender Populations 

Sexual Risk for HIV Transmission Among Gay/ 
Bisexual Men in Substance Abuse Treatment 

Paul, J-P-; Stall, R.; and Davis, F 
AIDS Education and Prevention, 5(1 ): 1 1 -24, 1 993 
Available from Progressive Research and Training 
for Action; Lesbian, Gay, and Transgender Tech- 
nical Assistance Project, 440 Grand Avenue, 
Suite 401 , Oakland, CA 9461 0-501 2; 51 0-465- 

This article reviews a study of San Francisco gay/ 
bisexual men in substance abuse treatment who 
were compared to the San Francisco Men's Healthy 
Study cohort. Statistics are given on the relation- 
ship between sexual risk behavior and substance 

Recnvery Needs uf Lesbian Alcoholics in 

Underbill B.L. 

N. Van Den Bergh (editor), Feminist Perspectives 
on Addictions, New York: Springer Publishing 
Company, 1991, pp. 73-86 

Available from Progressive Research and Training 
for Action; Lesbian, Gay, and Transgender Tech- 
nical Assistance Project, 440 Grand Avenue, 
Suite 401 , Oakland, CA 9461 0-501 2; 51 0-465- 

In this chapter, the author examines the specific 
needs of lesbian alcoholics in treatment and re- 
covery. Underhill points out the major barriers to 
treatment for lesbians are "cultural and external as 
well as interpsychic and internal." Incorporating a 
feminist analysis, the author looks at the struggles 
experienced by lesbians in treatment and recov- 
ery as they grapple with maintaining overall emo- 
tional well-being in a society that is heterosexual- 
centered, homophobic, and sexist. The specific 
areas of focus are: the scope of the problem, con- 
tributing factors, treatment, group focus on special 
topics (assertion techniques and anger), and fam- 
ily services. 

Substance Abuse Resource Guide 

Federal Resources 

and Internet Sites 

Center for Mental Health Services 
Knowledge Exchange Network (KEN) 
RO. Box 42490 
Washington, DC 2001 5 

Center for Substance Abuse Prevention (CSAP) 
Substance Abuse and Mental Health Services Adminis- 
tration (SAMHSA) 
5600 Fishers Lane 
Rockwall II Bldg., Suite 800 
Rockville, MD 20857 

800-729-6686 (SAMHSAs National Clearinghouse for 
Alcohol and Drug Information) 

Center for Substance Abuse Treatment (CSAT) 
Substance Abuse and Mental Health Services Adminis- 
tration (SAMHSA) 
5600 Fishers Lane 
Rockwall II Bldg., Room 618 
Rockville, MD 20857 

800-729-6686 (SAMHSAs National Clearinghouse for 
Alcohol and Drug Information) 

Centers for Disease Control and Prevention (CDC) 

Office on Smoking and Health 

Public Information Branch 

4770 Buford Highway, NE. 

Atlanta, GA 30341-3724 



Decision Support System for Prevention of Substance 


www. preventiondss.org 

National Health Information Center (NHIC) 

RO. Box 1133 

Washington, DC 2001 3-1 133 




National Institute on Alcohol Abuse and Alcoholism 


Wilco Bldg. 

6000 Executive Blvd., Suite 505 
Bethesda, MD 20892-7003 

National Institute on Drug Abuse (NIDA) 

6001 Executive Blvd., Room 5213 
MSC 9561 

Bethesda, MD 20892-9561 



National Institutes of Health (NIH) 
9000 Rockville Pike 
Bethesda, MD 20892 
301 -496-4000 


National Library of Medicine (NLM) 
8600 Rockville Pike 
Bethesda, MD 20894 

Office of Minority Health Resource Center 

RO. Box 37337 

Washington, DC 20013-7337 


TDD 301-230-7199 


Office of National Drug Control Policy (ONDCP) 

RO. Box 6000 

Rockville, MD 20849-6000 



SAMHSA's National Clearinghouse for Alcohol and 

Drug Information (NCADI) 

RO. Box 2345 

Rockville, MD 20847-2345 


800-487-4889 TDD 


Prevention Materials for Lesbian, Gay, Bisexual, and Transgender Populations 


Substance Abuse and Mental Health Services Adminis- 
tration (SAMHSA) 
5600 Fishers Lane 
Rockville, MD 20857 

Other Resources 

Affirmations Lesbian & Gay Community Center 
195 West Nine Mile Road, Suite 106 
Ferndale, Ml 48220 

Alcohol Center for Women, Inc. 
1 1 47 South Alvarado Street 
Los Angeles, CA 90006 

Alcoholics Anonymous 

World Service Office 

475 Riverside Drive, 11th Floor 

New York, NY 101 15 




Association for Gay, Lesbian & Bisexual Issues in 


(Division of American Counseling Association) 

Pastoral Counseling Center 

602 Southwest Madison Avenue 

Corvallis, OR 97333 


Association of Gay and Lesbian Psychiatrists (AGLP) 

4514 Chester Avenue 

Philadelphia, PA 19143-3707 



The Atlanta Gay and Lesbian Center 

828 West Peachtree Street 

Suite 207 

Atlanta, GA 30308 



Bailey Holt House 
1 80 Christopher Street 
New York, NY 1001 4 

Billy DeFrank Lesbian & Gay Community Center 

1 75 Stockton Avenue 

San Jose, CA 95126 



Black Lesbian Support Group (BLSG) 

Program of Lesbian Services 

Whitman Walker Clinic 

1407 S Street, NW. 

Washington, DC 20009 



Canadian Centre on Substance Abuse 

75 Albert Street, Suite 300 

Ottawa, Ontario 

Canada K1P 5 E7 



Center for Alternative Families 

425 Divisadero Street 

Suite 203 

San Francisco, CA 941 1 7 



The Center for Gay, Lesbian, Bi & Transgendered 

Life in Nashville 

703 Berry Road 

Nashville, TN 37204 

61 5-297-0008 


Central Toronto Youth Services 

Lesbian, Gay, and Bisexual Youth Program 

3rd Floor, 65 Wellesley Street, E. 

Toronto, Ontario 




Substance Abuse Resource Guide 

Church of the Open Door Community Center 
5954 South Albany Avenue 
Chicago, IL 60629 

Gay and Lesbian Community Center of New Jersey, Inc. 
626 Bangs Avenue 
Asbury Park, NJ07712 

City of Refuge United Church of Christ (UCC) 
1025 Howard Street 
San Francisco, CA 94103 

Committee on Lesbian and Gay Concerns 
American Psychological Association 
750 First Street, NE., #100 
Washington, DC 20002-4242 

Deaf, Gay and Lesbian Center 
150 Eureka Street, Suite 108 
San Francisco, CA 941 1 4 

EDUCARE Systems, Inc. 

Holistic Healing and Training Center 

1155 Connecticut Avenue, NW. 

Suite 300 

Washington, DC 20036 


Federal GLOBE (Gay, Lesbian, Bisexual Employees of the 

Federal Government) 

RO. Box 45237 

Washington, DC 20026-5237 


Gay and Lesbian Alliance Against Defamation (GLAAD) 


1 50 W 26th Street 

Suite 503 

New York, NY 10001 



Gay and Lesbian Community Center of Baltimore 

241 W. Chase Street 

Baltimore, MD 21201 



Gay and Lesbian Medical Association (GLMA) 

459 Fulton Street 

Suite 107 

San Francisco, CA 94102 


Gay and Lesbian Youth Support Project (GLYS) 
A Program of Health Care of Southeastern Massachu- 
setts, Inc. 

942 West Chestnut Street 
Brockton, MA 02301 
800-530-2770, X 214 

Gay, Asian and Pacific Islander Men of New York 

RO. Box 830 

Knickerbocker Station, NY 10002 



Gay, Lesbian and Straight Education Network (GLSEN) 

121 W. 27th Street 

Suite 804 

New York, NY 10001 



Gay Lesbian Association of Retired Persons 

10940 Wilshire Blvd., Suite 1600 

Los Angeles, CA 90024 



Gay, Lesbian and Bisexual Community Services Center of 


234 Broadway 

Denver, CO 80203 



Gay Men's Health Crisis, Inc. 
1 1 9 W. 24th Street 
New York, NY 10011 

Prevention Materials for Lesbian, Gay, Bisexual, and Transgender Populations 

Gayellow Pages 

RO. Box 533 

Village Station 

New York, NY 10014-0533 



Haight Ashbury Free Medical Clinic 

558 Clayton Street 

San Francisco, CA 941 1 7 



Human Rights Campaign 
919 18th Street, NW, Suite 800 
Washington, DC 20006 


Human Service Centers 

Lambda Treatment and Recovery Program 

87-08 Justice Avenue 

Suite 1 G 

Elmhurst, NY 11373 


International Gay and Lesbian Human Rights 


1360 Mission Street, Suite 200 

San Francisco, CA 94103 



International Lesbian and Gay Youth Organizations 


RO. Box 42463 

Washington, DC 20015-0463 



Jewish Alcoholic and Chemically Dependent Persons 

and Significant Others (JACS) 

850 Seventh Avenue 

New York, NY 1 001 9 



John Thomas Gay & Lesbian Community Center 

2701 Reagan Street 

RO. Box 1 90869 

Dallas, TX 7521 9-0869 



The Lambda Center 

4228 Wisconsin Avenue, NW. 

Washington, DC 2001 6 




Latino Gay Men of New York 
RO. Box 1103 
New York, NY 10025 

Lesbian and Gay Community Services Center 
Project Connect (Alcohol and Drug Abuse Coun- 

Youth Enrichment Services (Prevention) 
One Little West 1 2th Street 
New York, NY 1 001 4 

Lesbian and Gay Health Project 

RO. Box 3203 

Durham, NC 27715-3203 



Lesbian Community Project 
RO. Box 5931 
Portland, OR 97228 

Lesbian, Gay and Bisexual People in Medicine 

c/o American Medical Student Association 

1 902 Association Drive 

Reston, VA 20191 




Substance Abuse Resource Guide 

Lesbian/Gay Community Service Center of Greater 


6600 Detroit Avenue 

Cleveland, OH 44102 



Lesbian Resource Center 
2214 South Jackson Street 
Seattle, WA 981 44 

The Mautner Project for Lesbians with Cancer 

1 707 L Street, NW., Suite 500 

Washington, DC 20036 



Metropolitan Community Church 
World Headquarters 
8704 Santa Monica Blvd. 
West Hollywood, CA 90069 

Milwaukee LBGT Community Center 
RO. Box 51 11 89 
Milwaukee, Wl 53203-0201 
www. m ke Igbt. o rg 

Minnesota Indian Women's Resource Center 

2300 15th Avenue South 

Minneapolis, MN 55404 



National Alliance for Hispanic Health 
1 501 1 6th Street, NW. 
Washington, DC 20036-1401 

National Association of Alcoholism and Drug 

Abuse Counselors (NAADAC) 

1 91 1 North Fort Myer Drive 

Suite 900 

Arlington, VA 22209 




National Association of Lesbian and Gay 

Addiction Professionals, Inc. (NALGAP) 


1911 North Fort Myer Drive, Suite 900 

Arlington, VA 22209 



National Black Lesbian and Gay Leadership Forum 
1247 South Labrea 
Los Angeles, CA 9001 9 

National Center on Addiction and Substance 

Abuse at Columbia University 

633 Third Avenue 

1 9th Floor 

New York, NY 1 001 7-6706 



National Coalition for Lesbian, Gay and Bisexual 


RO. Box 24589 

San Jose, CA 951 54-4589 



National Council on Alcoholism and Drug 

Dependence, Inc. (NCADD) 

1 2 West 21 st Street, 7th Floor 

New York, NY 10010 




Prevention Materials for Lesbian, Gay, Bisexual, and Transgender Populations 


National Gay and Lesbian Task Force 
1 700 Kalorama Road, NW. 
Washington, DC 20009-2624 


National Latino/a Lesbian, Gay, Bisexual and 

Transgender Organization (LLEGO) 

1612 K Street, NW. 

Suite 500 

Washington, DC 20006 



National Lesbian and Gay Journalists Association 

2120 L Street, NW. 

Suite 840 

Washington, DC 20037 



National Native American AIDS Prevention Center 

436 14th Street, Suite 1020 

Oakland, CA 9461 2 



New Leaf Services 
1853 Market Street 
San Francisco, CA 94103 
41 5-626-7000 

Parents, Families and Friends of Lesbians and Gays 


1 726 M Street, NW, Suite 400 

Washington, DC 20036 



The Pride Center 

Tulsa Oklahomans for Human Rights, Inc. 

RO. Box 2687 

Tulsa, OK 74101 


Pride Institute 

14400 Martin Drive 

Eden Prairie, MN 55344 




Progressive Research and Training for Action 

440 Grand Avenue 

Suite 401 

Oakland, CA 9461 0-501 2 


TDD 510-465-2888 


Project Inform 

205 1 3th Street, Suite 2001 

San Francisco, CA 94103 



Project 1 00 

Hartford Gay and Lesbian Community Center 

1841 Broad Street 

Hartford, CT 061 14 


www.projectl 00htfd.com 

San Francisco Women's Building 

3543 18th Street 

San Francisco, CA 941 10 



Sexual Minority Youth Assistance League (SMYAL) 

410 7th Street, SE. 

Washington, DC 20003-2707 


TTY 202-546-7796 


SPHERE (Statewide Partnership for HIV Education 

in Recovery Environments) 

A Program of Health Care of Southeastern 

Massachusetts, Inc. 

942 West Chestnut Street 

Brockton, MA 02301 

800-530-2770, x233 

Substance Abuse Resource Guide 

Stonewall Alliance Center 
RO. Box 8855 
Chico, CA 95927 

Texas Commission on Alcohol and Drug Abuse 

RO. Box 80529 

Austin, TX 78708 



www. tcada . state . tx . us/ 

Therapeutic Communities of America (TCA) 

1611 Connecticut Avenue, NW. 

Suite 4-B 

Washington, DC 20009 



Tobacco Education Clearinghouse of California 

RO. Box 1 830 

Santa Cruz, CA 95061 -1 830 



US Helping US 
81 1 L Street, SE. 
Washington, DC 20003 

Washington State Alcohol and Drug 


3700 Rainier Avenue South 

Suite A 

Seattle, WA 981 44 



Whitman-Walker Clinic 
1407 S Street, NW. 
Washington, DC 20009 


William Way Lesbian, Gay, Bisexual & Transgender 

Community Center 

1315 Spruce Street 

Philadelphia, PA 19107-5601 



Wisconsin Clearinghouse 

University Health Services 

University of Wisconsin-Madison 

1 552 University Avenue 

Madison, Wl 53705-4085 


800-248-9244 (Wisconsin residents only) 


Prevention Materials for Lesbian, Gay, Bisexual, and Transgender Populations 


Center for 
Substance Abuse 

Substance Abuse and Mental 
Health Services Administration 

DHHS Publication No. (SMA) 94-2097 

Revised 2000 www.samhsa.gov